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THE 
 
 ANATOMY 
 
 or THE 
 
 HUMAN BODY. 
 
 BY WILLIAM CHESELDEN, 
 
 Surgeon to his Majesty’s Royal Hospital at Chelsea, Fellow of the Royal 
 Society, and Member of the Royal Academy of Surgeons 
 at Paris. 
 
 f 
 
 mitfy jTortp Copperplates, 
 
 SECOND AMERICAN EDITION, 
 
 BOSTON: 
 
 PUBLISHED BY DAVID WEST, N*“. 56, CORNHIL&, 
 
 C. STEBBINS, PRINTER, 
 
 jan. 1806, 
 
i 
 
 
 
 
 
 
TO 
 
 DR. RICHARD MEAD, 
 
 PHYSICIAN TO THE KING, 
 
 FELLOW OF THE COLLEGE OF PHYSICIANS 
 Ijy l o j\~d o a; 
 
 AND OP THE 
 
 ROYAL SOCIETY. 
 
 sir, y 
 
 EVERY part of PHYSIC may justly pre- 
 sume on your protection, to whom it owes so 
 much improvement. ANATOMY in particular 
 has received such advantage from your lectures, 
 that it were a kind of injustice not to dedicate 
 all endeavours in that way to you ; in me, in- 
 deed, it would be unpardonable not to offer the 
 fruits of those studies, which at first began, and 
 have still been carried on with your encourage- 
 ment. The kind reception my industry has met 
 with, is owing to you, the authority of whose 
 
DEDICATION. 
 
 opinion has in every place secured me so much 
 favour j especially in that seat of learning, which 
 with distinguished honours rewarded your merit, 
 
 I am, SIR, 
 
 Tour most obliged and 
 Obedient humble servant , 
 
 WILLIAM CHESELDEN. 
 
PREFACE. 
 
 THE study of anatomy, as it leads to the knowl- 
 edge of nature and the art of healing , needs not many 
 tedious descriptions nor minute dissections ; what is most 
 worth knowings is soonest learned , and least the subject 
 of disputes ; while dividing and describing the parts , 
 more than the knowledge of their uses requires , perplexes 
 the learner , and makes the science dry and difficult. 
 
 This edition is a tenth part larger than the former ; 1 
 not increased by descriptions , but by observations upon the • 
 uses and mechanism of the parts , with operations and 
 cases in Surgery. 
 
 ■ The plates are more in number , larger ■, better de- 
 signed , and better executed than those which were in the 
 former editions , which has unavoidably enhanced the 
 price of this. 
 
CONTENTS. 
 
 BOOK I. 
 
 Page 
 
 THE General Introduction 1 
 
 Introduction to the Bones 4 
 
 Chap. I. Of the Sutures and Bones of the Cranium 11 
 Chap. II. Of the Bones of the Face , lAc. 17 
 
 Chap, III. Of the Bones of the Trunk 21 
 
 Chap. IV. Of the Bones of the Upper Limbs 29 
 
 Chap. V_ Of the Bones of the Lower Limbs 34 
 
 Chap. VI. Of the Cartilages 41 
 
 l Of the Ligaments 44 
 
 Of the Lubricating Glands of the Joints 47 
 
 BOOK II. 
 
 Chap. I. 
 
 Introduction to the Muscles 
 
 61 
 
 Chap. 1 1. 
 
 Of the Muscles 
 
 67 
 
 
 BOOK III. 
 
 
 Chap. I. 
 
 Of the External Parts , and Common 
 
 
 
 Integuments 
 
 133 
 
 Chap. II. 
 
 Of the Membranes in general 
 
 141 
 
 Chap. III. 
 
 Of the Salivary Glands 
 
 142 
 
 Chap. IV. 
 
 Of the Peritonaum , Omentum , Duc- 
 tus Aliment alls, and Mesentery 
 
 148 
 
CONTENTS. 
 
 Page 
 
 Chap. V. 
 
 Of the Liver, Gall-Bladder , Pancreas , 
 
 
 
 and Spleen 
 
 161 
 
 Chap. VI. 
 
 Of the Vasa Lactea 
 
 163 
 
 Chap. VII. 
 
 Of the Pleura , Mediastinum , Lungs , 
 
 
 
 Pericardium and Heart 
 
 172 
 
 Chap. VIII. 
 
 Of the Arteries and Veins 
 
 183 
 
 Chap. X. 
 
 Of the Lymph <z ducts 
 
 209 
 
 Chap. XI. 
 
 Of the Lymphatic Glands 
 
 212 
 
 Chap. XII. 
 
 Of the Course of the Aliment abstract- 
 
 
 
 ed from the foregoing Chapters 
 
 216 
 
 Chap. XIII. 
 
 Of the Dura Mater , and Pia Mater 
 
 218 
 
 Chap. XIV. 
 
 Of the Cerebrum , Cerebellum, Medul- 
 
 
 
 la Oblongata , and Medulla Spinalis 
 
 222 
 
 Chap. XV. 
 
 Of the Nerves 
 
 225 
 
 
 BOOK IV. 
 
 
 Chap. I. 
 
 Of the Urinary and Genital Parts of 
 
 • 
 
 ' 
 
 Men, together with the Glandules 
 
 
 
 Renales 
 
 259 
 
 Chap. II. 
 
 Of the Genital Parts of Women 
 
 272 
 
 Chap. III. 
 
 Of the Foetus in Utero 
 
 278 
 
 Chap. IV. 
 
 Of the Eye 
 
 290 
 
 Chap. V. 
 
 Of the Ear 
 
 304 
 
 Chap. VI. 
 
 Of the Senses of Smelling , Tasting and. 
 
 
 
 Feeling 
 
 310 
 
 Chap. VII. 
 
 Of Cutting for the Stone 
 
 325 
 
ADVERTISEMENT. 
 
 SINCE the last edition of this book, I have pub- 
 lished some Observations and Cases in Surgery, with 
 prints of Operations and a Set of Chirurgical Instru- 
 ments. These are annexed to a Translation of Le 
 Bran’s Operations by Mr. Gataker ; and as some 
 of them relate to my Anatomy, I thought it proper 
 to take notice of them here : at the same time, in 
 justice to the merit of Mr. Le Dran, I would recom- 
 mend a careful perusal of his Book to all Practition- 
 ers in Surgery. 
 
 W. CHESELDEN. 
 
THE 
 
 ANATOMY 
 
 or THE 
 
 HUMAN BODY. 
 
 GENERAL INTRODUCTION. 
 
 It is a received opinion, that an animal body ' 
 is a compages of vessels, variously disposed, to 
 form parts of different figures, for different uses. 
 The ancients supposed that the heart and brain 
 were first formed, and that the other parts pro- 
 ceeded from them, and that the membranes were 
 derived from the dura mater, or pia mater of 
 the brain. They distinguished all the parts into 
 spermatic and sanguineous ; the former of which 
 they derived from the brain, and the latter from 
 the heart ; and frequently engaged in disputes 
 about the derivation of parts ; with many other 
 things of the like nature, consequences of their 
 hypotheses. But the moderns, by the assist- 
 
 B 
 
2 
 
 GENERAL INTRODUCTION', 
 
 ance of glasses, having made more accurate observ 
 vations, conclude, that all the parts exist in minia- 
 ture, from the first formation of the foetus ; and 
 that their increase is only the extension and thick- 
 ening of their vessels, and that no part owes its ex- 
 istence to another. Thus much I thought neces- 
 sary to premise, that the reader might see for 
 what reason no notice is taken, in this treatise, of 
 some distinctions and divisions of parts, used by 
 ancient anatomists, and those who have copied af- 
 ter them. 
 
 The constituent parts of the animal body, are, 
 fibres, membranes, arteries, veins, lymphaeducts, 
 nerves, glands, excretory vessels, muscles, tendons, 
 ligaments, cartilages, and bones j to these may be 
 added, the hair and nails. 
 
 Fibres, as they appear to the naked eye, are sim- 
 ple threads of the minutest blood vessels or nerves, 
 or both. 
 
 Membranes are compages of fibres, expanded to 
 cover, or line, any other part. 
 
 Arteries are tubes that arise from the ventricles 
 of the heart, and thence dividing into branches, dis- 
 tribute the blood to every part of the body. 
 
 Veins are tubes to collect and return the blood 
 from the extremities of the arteries to the heart. 
 
 Lymphasducts are fine pellucid tubes, to carry 
 lymph from all par's, especially the glands, which 
 they discharge into the larger veins, and into the 
 vasa lactea. 
 
GENERAL INTRODUCTION. 
 
 3 
 
 Nerves are fasciculi of cylindrical fibres, which 
 arise from the medulla oblongata of the brain, 
 and the medulla spinalis, and terminate in ail 
 the sensitive parts. They are the immediate organs 
 of sensation. 
 
 A gland secretory, is composed of an artery, 
 vein, lymphatic, excretory duct, and nerve. The 
 use of glands is to secrete fluids from the blood, for 
 divers uses. 
 
 Excretory vessels are either tubes from glands 
 to convey the secreted fluids to their respect- 
 ive places ; or vessels from the small guts, to carry 
 the chyle to the blood vessels ; these last are called 
 vasa lactea. 
 
 Muscles are distinct portions of flesh, which by 
 contracting, perform the motions of the body. 
 
 Tendons are the same fibres of which the mus- 
 cles are composed ; but more closely connected, 
 that they may possess less space in a limb, and be 
 inserted in less room into a bone. 
 
 Ligaments are strong membranes, or bodies of 
 fibres closely united, either to bind down the 
 tendons, or give origin to the muscles, or tie to- 
 gether such bones as have motion. 
 
 Cartilages are hard, elastic bodies, smooth and 
 insensible ; their use is to cover the ends of the 
 bones that have motion, to prevent their attri- 
 tion, &c. 
 
 Bones are firm parts to sustain, and give shape 
 to the body, &c. 
 
INTRODUCTION TO THE BONES. 
 
 The use of the bones is to give shape and 
 firmness to the body, to be levers for the mus- 
 cles to act upon, and to defend those parts from 
 external injuries that are of greatest consequence 
 to be preserved ; as the brain, spinal marrow, 
 heart, &c. Their fibres, when first formed like 
 the shells and stones of fruits, are very soft, un- 
 til by the addition of a matter, which is secreted 
 into them, they grow by degrees to the hardness 
 of a cartilage, and then perfect bone : but this 
 change is neither made in a very short time, nor 
 begun in all the parts of the same bone at once. 
 Flat bones, that have their fibres directed to all 
 sides, begin to ossify in or near a middle point ; but 
 the cylindrical bones, and all others whose fibres are 
 nearly parallel, begin about the middle of each fibre, 
 and thence shoot forth to their extremities ; not 
 always in continued lines, but frequently beginning 
 new ossifications, which soon join the former ; and 
 by the continual addition of this ossifying matter, 
 the bones increase till their hardness resists a far- 
 ther extension ; and their hardness always increas- 
 ing while they are growing, the increase of their 
 growth becomes slower and slower, until they cease 
 
5 
 
 INTRODUCTION, &C. 
 
 to grow at all. In old and consumptive persons, 
 and sometimes in diseased or wounded limbs, they 
 decrease as well as the fleshy parts, though not so 
 fast, because of their hardness. Sometimes the os- 
 sifying matter flows out of the bones, and forms 
 bony excrescences ; and frequently in very old men 
 it fixes on the arteries, and makes them grow bony ; 
 and when this happens to a degree, the arteries 
 lose their power to propel the blood, until the ex- 
 treme parts mortify. And though the cartilages 
 and arteries are most subject to these changes, yet 
 no part is secure from them ; for I have seen a 
 large part of the muscular fibres of the heart itself 
 perfectly ossified. I have known one instance of a 
 deficiency of this ossifying matter, in the lower jaw 
 of an adult body ; where all that part on one side, 
 which is beyond the teeth, was of a substance be- 
 tween that of a cartilage and a ligament. In chil- 
 dren that have died of the rickets, I have found the 
 nodes on the bones soft, spongy, and bloody, and 
 in one subject several of them as limber as leather, 
 and the periosteum in some places many times its 
 natural thickness ; but the cartilages and cartilagin- 
 ous epiphyses had no apparent alteration in their 
 texture, though some were swelled to more than 
 twice their natural diameters. 
 
 Every cylindrical bone has a large middle cav- 
 ity, which contains an oily marrow, and a great 
 number of lesser cells towards their extremities, 
 which contain a bloody marrow. The bloody 
 
6 
 
 INTRODUCTION 
 
 marrow is also found in all spongy cells of bones. 
 The use of the first kind of marrow, I imagine, 
 is to soften, and render less brittle, the harder fi- 
 bres of bones near which it is seated ; and that 
 the other marrow is of the same use to the less 
 compact fibres, which the more oily marrow might 
 have made too soft ; and that for this reason there is 
 less of the oily marrow, and more of the bloody, 
 in young bones than in old ones. Every one of 
 these cells is lined with a fine membrane, and the 
 marrow in the larger cells is also contained in 
 thin membraneous vesicles ; in which membranes 
 the vessels are spread, which enter obliquely, 
 about the middle of the cylindrical bones, from 
 some of whose branches the marrow is secreted, 
 while others of them enter the internal substance 
 of the bones for their nourishment ; and the rea^ 
 son why they enter obliquely is, that they may 
 not weaken the bones by dividing too many fi- 
 bres in the same place. If the bones had been 
 formed of the same quantity of matter without any 
 cavities, they would, if they were straight, be able 
 to sustain the same weight ; but being made hollow, 
 their strength to resist breaking transversely is in- 
 creased as much as their diameters are increased, 
 without increasing their weights ; which mechan- 
 ism being yet more convenient for birds, the bones 
 of their wings, and for the same reason their quills, 
 have very large cavities. But the bones in the legs 
 of all animals are more solid, being formed to sup* 
 
TO THE BONES. 
 
 7 
 
 port weight ; and men’s bodies being supported by 
 two limbs, the bones of those limbs are therefore 
 made more solid than those of quadrupeds. In- 
 sects, and most of the smallest animals, have shelb 
 instead of bones, like lobsters, which serve them al- 
 so for defence ; and the muscles, being inserted into 
 the shells at a greater distance from the centre of 
 motion of each joint than in animals that have 
 bones, their motions are necessarily slower, stronger 
 and more simple. Therefore in this sort of animals, 
 quickness of motion, where it is wanted, is pro- 
 cured by a number of joints, as may be seen in the 
 legs of a flea ; and variety of motions by joints 
 with different directions, as may be observed in a 
 lobster. In a fractured bone, in which the same 
 kind of matter that ossified the bones at first is 
 thrown out from the broken ends of a bone, there 
 is formed a mass of callous matter, of equal solid- 
 ity with any part of the bone, and of equal or 
 greater diameter, which will make the strength 
 of the bone in that place greater than it was be- 
 fore ; which is very convenient ; for bones, when 
 broke, are seldom or never set in so good a direc- 
 tion as that in which they were first formed, and 
 therefore they would be more liable to be broke 
 in the same place again, and would be reunited 
 with greater difficulty, and sometimes not at all, 
 because the callus, being less vascular than a bone, 
 is does not so easily admit the ossific matter to flow 
 through it to form a new callus. 
 
INTRODUCTION 
 
 Bones that are without motion, as those of the 
 scull, the ossa innominata, &c. also bones with 
 their epiphyses, when they meet, press into each 
 other, and form sutures, which soon disappear in 
 those that join, while their ossific matter is soft $ 
 but those that grow harder before they meet, press 
 more rudely into each other, and make more un- 
 even sutures, some of which in the scull endure to 
 the greatest age : and sometimes while a bone is 
 ossifying from its centre, a distant part begins a new 
 ossification, and forms a distinct bone, which may 
 happen to be of any figure. These bones are often- 
 est found in the lambdoital suture, and are there 
 called ossa tiiquetra. But the ends or sides of bones 
 that are intended for motion, are hindered from 
 uniting, by the cartilages which cover them ; for 
 when these cartilages are eroded, the bones very 
 readily unite, and form an anchylosis. 
 
 The ends of all the bones that are articulated 
 for very manifest motions, or that are not placed 
 against other bones ; are tipped with epiphyses or 
 additional bones ; which in some measure de- 
 termine their growth and figure ; for if they had 
 nothing to give bounds to them, they would shoot 
 out like the callus from the broken ends of a bone 
 that is ill set, and grow as ragged as the edges of 
 bones which are joined by sutures ; and sometimes 
 epiphyses are made use of to raise processes upon 
 bones for the insertions of muscles, as the trochan- 
 ters of the thigh bones, where it would weaken 
 
TO THE BONES. 
 
 9 
 
 the bones too much to have processes raised out of 
 their substance. 
 
 The fibres of bones, for aught that we can dis- 
 cover from experiments or microscopical observa- 
 tions, appear to be connected to each other by the 
 same means that the parts of a fibre are connected, 
 that is, by the strong attraction which belongs to 
 particles of matter in contact ; but this cohesion 
 of fibre to fibre is not equal to that in the parts of 
 a fibre, though very nearly. Indeed if it was, a 
 bone would not be a structure of fibres, but one 
 uniform mass, like that of any pure metal, the co- 
 hesion of the parts of which are every where alike. 
 Nor are the parts of bones disposed into visible la- 
 mellae, stratum super stratum, as many have paint- 
 ed ; for though young bones may in some places 
 be split into lamellae, yet they not only appear one 
 solid uniform mass to the naked eye, but even with 
 a microscope, till we come to their inner spongy 
 texture, which also appears uniform. Their tex- 
 ture, when first formed, is every where loose and 
 spongy : but as they increase, they become in ma- 
 ny places very compact and dense, which results in 
 great measure from the pressure of the bellies of 
 the muscles, and other incumbent parts ; as ap- 
 pears from the impressions they make on the sur- 
 faces of the bones, and the rough spines that rise 
 on the bones in the interstices of the muscles, which 
 are very remarkable in men who have been bred 
 up in hard labour. In those parts of the flat bones 
 
10 
 
 INTRODUCTION, &C. 
 
 that receive but little pressure, the outer laminss 
 only become compact and dense, while the mid- 
 dle part remains spongy ; but where the pressure 
 is greater, as on the scapula and the middle of 
 the ilium, they become in an adult, one dense 
 body or table, and are usually thinner in those 
 places than in a child before it is born. The cy- 
 lindrical or round bones, being pressed most in 
 their middles, become there very hard and strong, 
 while their extremities remain spongy, and dilate 
 into large heads, which make stronger joints, and 
 give more room for the origins and insertions of 
 the muscles ; and increase the power of the mus- 
 cles, by removing their axis farther from the 
 centre of motion of any joint they move. 
 
 All the bones, except so much of the teeth 
 as are out of the sockets, and those parts of other 
 bones which are covered with cartilages, or 
 where muscles or ligaments arise or are inserted, 
 are covered with a fine membrane, which upon 
 the scull is called pericranium, elsewhere peri- 
 osteum. It serves for the muscles to slide easy 
 upon, and to hinder them from being lacerated by 
 the roughness and hardness of the bones. It is 
 every where full of small blood vessels, which en- 
 ter the bones for their nourishment ; but the in- 
 ternal substance of the larger bones is nourished 
 by the vessels which enter obliquely through 
 their middles, as has been before observed. 
 
11 
 
 SUTURES AND BONES, &C. 
 
 CHAPTER I. 
 
 SUTURES AND BONES OF THE CRANIUM. 
 
 SUTURE is made by the mutual indenta- 
 tion of one bone with another. Those which 
 have proper names are here described ; those 
 which have not, derive their names from the 
 bones they surround, and are known by them. 
 
 Sutura coronalis runs across the scull, from one 
 upper edge of the sphenoidal bone to the other, 
 and joins the parietal bones to the frontal. 
 
 Sutura sagittalis joins the parietal bones ; be- 
 gins at the os occipitis, and is continued to the os 
 frontis, in children down to the nose ; the os fron- 
 ds in them being two bones, and sometimes so in 
 adult bodies. 
 
 Sutura tambdoidalis joins the back part of the 
 ossa bregmatis, or parietal bones, to the upper part 
 of the occipital : in this suture are frequently ob- 
 served small bones called ossa triquetra, and some- 
 times in other sutures. 
 
 Sutura squamosa is made by the upper part of 
 the temporal and spenoidal bones wrapping over 
 the lower edges of the parietal bones. 
 
 Sutura transversalis runs across the face through 
 the bottoms of the orbits of the eyes ; it joins the 
 lower edge of the frontal bone to the os spenoides, 
 maxillae superioris, ossa nasi, ungues plana, pala- 
 ti, and jugalia, or malarum. 
 
12 
 
 SUTURES AND BONES 
 
 The scull being divided into many bones, is 
 neither so subject to fractures, nor to have fractures 
 so far extended, as it would have been were it 
 composed of one bone only. This structure is also 
 convenient for the ossification of the bones, as has 
 been already shewn, and for the birth ; because 
 these bones not being perfect at that time, may 
 be pressed together, and make the head less. 
 
 Ten of the bones of the head compose the 
 cranium, to contain the brain and defend it fx'om 
 external injuries. 
 
 Ossa parietalia, or bregmatis are two large 
 bones which compose the superior and lateral parts 
 of the scull ; on the inside they are remarkably 
 imprinted by the arteries of the dura mater. 
 
 Os frontis makes the upper and fore part of the 
 cranium ; its lower parts compose the upper parts 
 of the orbits of the eyes, where on its insides are 
 impressed the volvuli of the brain, which uneven- 
 nesses help to keep that part of the brain steady. 
 In its middle above the os ethmoiaes usually arises 
 a thin spine, which strengthens that part of the 
 bone, it being otherwise weak from its flatness. 
 In some sculls this spine is wanting ; but then the 
 bone is usually thicker in that place, and from its 
 middle, externally, goes a process which supports 
 the bones of the nose. Immediately above the os 
 ethmoides in this bone is a small blind hole, through 
 which runs a vein into the beginning of the longi- 
 tudinal sinus of the dura mater ; and on the upper 
 
OT THE CRANIUM. 
 
 is 
 
 edge of each orbit, a small perforation, or a notch, 
 through which nerves and an artery pass secure to 
 the forehead ; it has also a small hole in each orbit, 
 near the os planum, through which passes a branch 
 of the fifth pair of nerves. In the substance of 
 this bone near the nose are two, three, four, and 
 sometimes five sinuses, which open into the nose ; 
 they differ very much in different persons, and are 
 very rarely found in children. These sinuses, and 
 the spine in this bone, make it very dangerous, if 
 not impracticable, to apply a trephine on the mid- 
 dle and lower part of the forehead. 
 
 Os esthmoides, or cribriforme, is a small 
 bone, about two inches in circumference, seated in 
 the anterior part of the basis of the scull, being al- 
 most surrounded by the last described bone. It is 
 full of holes, like a sieve, through which, it is said, 
 the olfactory nerves pass, which I could never dis- 
 cover. In its middle arises a large process named 
 crista galli : and opposite to this a thin one which 
 in part divides the nose. The greater part of the 
 laminae spongiosae in the nose belong to this bone. 
 
 Os sphenoides is of a very irregular figure ; it 
 is seated in the middle of the basis of the scull, 
 bounded by the os frontis, ethmoides, vomer, occi- 
 pitis, maxillae superioris, ossa parietalia, palati, ma- 
 larum, temporum, and petrosa, which are parts of 
 the former bones. In its inside next the brain is a 
 cavity named sella turcica, which isboundedby four 
 processes called clinoides : under the two foremost 
 
14 
 
 SUTURES AND BONES 
 
 of which pass the internalcarotid arteries, and from 
 their outsides are continued two thin long processes 
 upon that part of the frontal bone, which separates 
 the anterior lobes of the brain from the posterior ; 
 opposite to the sella turcica is a process which makes 
 part of the septum narium. On the outside of the 
 scull adjoining to the upper jaw, are two processes 
 of this bone on each side, named pterygoides from 
 which arise one on each side near the palate, which 
 have no name. Over these pass the tendons of the 
 pterygostaphilina externi muscles ; and nearer to- 
 wards the occiput, between these and the styloid 
 processes of the ossa petrosa, arise two more small 
 rugged processes ; and under the sella turcica, in 
 this bone, is a sinus or two, for the most part, in 
 adults, but in children only such a spongy substance 
 as is seen in the ends of some of the bones. Dr. 
 Nichols observes, this sinus belongs properly to 
 the os ethmoides. At the inside of the basis of the 
 two antei'ior clinoid processes are two round holes, 
 which are the first foramina of the scull ; through 
 these the optic nerves pass ; almost under these, to- 
 wards the sides of the scull, are two irregular slits, 
 named foramina lacera, or the second foramina of 
 the scull, through which pass nerves and blood 
 vessels into the orbits of the eyes; and under these, 
 towards the occiput, are two round holes, which 
 are the third foramina, through which pass nerves 
 to the face ; about half an inch nearer the occiput 
 are two more, of an oval figure, which are the 
 
OF THE CRANIUM. 
 
 15 
 
 fourth foramina, through which pass the largest 
 branches of the fifth pair of nerves ; and a straw’s 
 breadth farther two very small ones, called the fifth 
 foramina, through which those branches of the ca- 
 rotid arteries enter that are bestowed upon the du- 
 ra mater. Between this last described bone and 
 the ossa petrosa, are two large rough holes, in 
 which I have seen large veins ; and frbm these 
 holes, through part of the os sphenoides under the 
 pterygoid processes, are small holes, through which 
 pass arteries to the back part of the nose. 
 
 Ossa temporum are situated below the parie- 
 tal bones, at the middle and lower parts of the 
 sides of the scull ; they have each at their back 
 parts one large spongy process, called mammilla- 
 ris, or mastoideus, and from the lower and middle 
 parts of each a process which joins the ossa mala- 
 rum, named jugalis or zygomaticus. 
 
 Ossa petrosa lie between the former bones 
 and the occipital bones, or are truly portions of the 
 former bones, being never found separate in adult 
 bodies. They have each on their outsides one long 
 slender process called styliformis, and near the side 
 of this process a foramen, which runs obliquely 
 forwards into the scull, through which the carotid 
 arteries pass to the brain ; these are the sixth fora- 
 mina, and one foramen in the inside of the scull 
 leading to the organs of hearing, which are the sev- 
 enth foramina. The ridge on the upper parts of 
 each of these bones helps to keep the brain steady, 
 
16 
 
 SUTURES AND RONES 
 
 and are strong supports to the thin and flat parts 
 of the scull, which else would be exceeding weak. 
 What remains of this bone belongs properly to a 
 discourse on the organs of hearing. 
 
 Between the last described bones and the fol- 
 lowing bone are two large holes, which are the 
 eighth foramina. Through these holes pass the 
 eighth pair of nerves and lateral sinuses some- 
 times they are two on each side, one for the nerve 
 and one for the sinus. To these we may add an- 
 other very small one on each side, through which 
 pass the portiones durae of the auditory nerves ; 
 and sometimes there is another for an artery. 
 
 Os occipitis makes all the back part of the 
 scull ; it is bounded by the sphenoidal, temporal, 
 petrosal, and parietal bones ; it has two small, 
 apophyses, by which it is articulated to the spine 
 near those apophyses are two small foramina, 
 which are the ninth of the scull ; through these 
 pass the ninth pair of nerves ; and between these 
 is the great or tenth foramen, through which the 
 medulla oblongata descends into the spine, the cer- 
 vical arteries enter, and the cervical veins pass out. 
 In the inside of this bone is a crucial spine im- 
 pressed by the longitudinal and lateral sinuses : 
 and on the outside, opposite to the middle of this 
 spine, in some bodies, is an apophysis, and from, 
 that down to the great foramen a small thin spine. 
 The spines in this bone are of the same use with 
 those in the os frontis, &c. viz. to strengthen it. 
 
OF THE CRANIUM. 
 
 17 
 
 The thinner parts of this bone are also defended by 
 the muscles that cover them ; which provision is 
 very necessary, because we can least defend this 
 part, and blows here are of worse consequence than 
 on any other part of the scull, because wounds in 
 the cerebellum, which is underneath, are mortal. 
 There are in most sculls a foramen behind each 
 apophysis of the occipital bone ; through which 
 pass sinuses from the lateral sinuses to the external 
 cervical veins: by means of these communications, 
 as in all other communications of the sinuses, the 
 blood passes from those that happen to be sur- 
 charged by any posture of the head, into those 
 that from the same posture would have been al- 
 most empty. Such sculls as want these foramina 
 have two sinuses for the same purpose. 
 
 CHAPTER II. 
 
 OF THE BONES OF THE FACE, &C. 
 
 Ossa nasi make the upper part of the nose ; 
 they form that kind of arch which is fittest to sus- 
 tain such injuries as the nose is most exposed to. 
 
 Ossa malarum. These bones compose the an- 
 terior, lower, and outer parts of the orbits of the 
 eyes ; they have each a short process, which pro- 
 cess joins the processus jugales of the temporal 
 
18 
 
 OF THE BOKES 
 
 bones, and form arches which have been called' 
 ossa jugalia. 
 
 Ossa ungues are seated immediately below the 
 os frontis towards the nose in the orbits of the 
 eyes ; whose anterior and inner parts they help 
 to compose ; and between each of them and the 
 upper jaw is a foramin as large as a goose quill, in- 
 to which the punctalacrymalia lead, to carry off any 
 superfluous moisture from the eyes into the nose. 
 
 Ossa plana are seated immediately beyond the 
 foregoing bones, in the orbits of the eyes, and 
 are near thrice as big. They are rather smooth 
 surfaces of the os spongiosum, than distinct bones., 
 and are very often imperfect. 
 
 Maxilla superior is always described single 
 ' though it is manifestly divided by a suture which 
 , is scarce ever obliterated ; it has two processes, 
 < which join the os frontis, and make part of the 
 nose ; and another, which joins to the cartilage of 
 the septum nasi. Its upper and outward parts make 
 the lower parts of the orbits of the eyes ; its lower 
 side, all that part of the face under the cheeks, 
 eyes, .and nose to the mouth, and two thirds of the 
 roof of the mouth. A little below the orbits of the 
 eyes, in this bone, are two holes, and behind the 
 dentes incisores one more, which divides into two, 
 as it opens into "the nose, on each side of the sep- 
 tum nasi. Between the posterior grinding teeth 
 and the orbits of the eyes are two great sinuses, 
 called antra maxillae superioris, which open in the 
 
OF THE FACS. 
 
 19 
 
 nipper part of the nose. And in the lower edge of 
 this jaw are the alveoli, or sockets for the teeth. 
 
 Part of the sides of these cavities, that lie next the 
 -nose, are only membranes which make the cavities 
 like drums, perhaps to give a grave sound to the 
 voice when we let part of it through the nose ; 
 but brutes not needing such variety of sounds, have 
 these cavities open to the nose, and filled with la- 
 mellae, which are covered with membranes, in 
 which the olfactory nerves terminate, for a more 
 exquisite sense of smelling than is necessary for 
 men. Imposthumations sometimes happen in 
 these cavities : the signs of this disease are, great 
 pain about the part, matter in the nose on the side 
 diseased, stinking breath, and rotten teeth. Mr. 
 Cowper first described this case, and the cure ; ^ 
 
 which is performed by drawing out the last tooth * 
 but one, or two, or more if rotten ; and through 
 their socketsmakingaperforation,intothe antrum; 
 or if drawing a tooth makes a perforation, which 
 sometimes happens, and perhaps gave the first hint 
 of this cure, then that opening must be enlarged, 
 if it is not sufficient to discharge the matter. 
 
 Ossa palati are two small bones that make 
 the back part of the roof of the mouth, and a small 
 part of the bottom of each orbit. Between the ossa 
 palati and osmaxillare near the pterygoid processes 
 of the sphenoidal bone, are too small foramina, 
 through which arteries and nerves pass to the pal- 
 ate. 
 
20 
 
 OF THE BONES 
 
 Os Vomer is seated between the bones of the 
 palate, and the sphenoidal bone. It is also joined to 
 the process of the ethmoides, and part of the low- 
 er jaw. Its fore part is spongy, and is continued 
 to the middle cartilage of the nose. This bone 
 and cartilage are the septum nasi. 
 
 Os spongiosum is usually treated as a distinct 
 bone, though it is only the spongy laminae in the 
 nose, of the os ethmoides and ossa plana, but chiefly 
 of the os ethmoides, to which it always adheres. 
 In considering these lamellae as a distinct bone, we 
 follow the ancients, who did not distinguish the 
 bones of the scull only, as they are divided by su- 
 tures, but according to the differences of their tex- 
 ture, figure, situation, or use. Thus they called 
 these parts os spongiosum ; a process of the tempo- 
 ral bone, joined to the os malae, os jugale, &c. 
 
 Maxilla inferior is articulated with loose car- 
 tilages to the temporal bones, by two processes, 
 named condyloides. Near these arise two more, 
 called coronales, and at the inside of the chin a 
 small rough processus innominatus. In the inside 
 of this bone, under each processus coronalis, is a 
 large foramin, which runs under the teeth, and 
 passes out near the chin. In this foramen, the ves- 
 sels pass that belong to the teeth ; and in the upper 
 edge of this jaw are the sockets for the teeth, which 
 seldom exceed sixteen in each jaw ; the four first 
 in each are called incisores, the two next canini, 
 the rest molares 5 the four last of these are named*" 
 
OF THE FA-CE. 
 
 21 
 
 dentes sapientiae, because they do not appear till 
 men arrive at years of discretion. The incisoresand 
 canini have only one single root, but the molares 
 more; the eight first, two; and the rest, some three, 
 some four, especially in the upper jaw; where also 
 they are spread wider, because that jaw being more 
 spongy than the other, the teeth need more space 
 to fix them. Each of these roots has a foramen, 
 through which pass an artery, vein, and nerve, 
 which are expanded in a fine membrane that lines 
 the cavity in each tooth. These vessels and mem- 
 brane are the seat of the tooth-ache. The teeth of 
 children cast off while they are growing ; but the 
 succeeding teeth arise in new sockets, deeper and 
 larger than the former, for the jaws increasingfast- 
 er than the teeth, must otherwise have left chasms 
 between them,suchas are in the mouths of brutes ; 
 but where teeth are drawn in adult bodies, the 
 sockets close, and new ones very rarely succeed. 
 
 CHAPTER IE. 
 
 OF THE BONES OF THE TRUNK. 
 
 The bones of the trunk are those which com- 
 pose the spine or chain of bones from the head 
 down to the rump, the ribs and sternum, to which 
 may justly be added the the ossa innominata. 
 
 The spine is composed of twenty-four vertebrae 
 (each of which in a young child is three bones) 
 
22 
 
 er THE BONES 
 
 'besides those of the os sacrum and coccygis ; sev- 
 en belong to the neck, the first of which is called 
 atlas, because it immediately supports the head ; 
 its upper side has two cavities, into which the apo- 
 physes of the os occipitis are received ; but these 
 two cavities together, unlike all other joints, are 
 laterally portions of concentric circles, by which 
 means they are but as one joint, and so suffer the 
 head to move easily side-ways, which otherwise it 
 could no more do than the knee, which also has 
 two heads and two cavities. The under side of 
 this bone has a very flat articulation with the next, 
 which fits it for a rotatory motion. The second 
 vertebra is called dentata, or axis, from a process 
 which passes through the former bone, and is the 
 axis upon which it turns ; nevertheless all the ver- 
 tebrae of the neck contribute something to the ro- 
 tatory motion of the head. The processus denta- 
 tus is strongly tied to the os occipitis, and to the 
 atlas by ligaments to prevent its hurting the spi- 
 nal marrow. Twelve of which belong to the 
 bacjc, five to the loins. The os sacrum is some- 
 times five, sometimes six bones, and the os occygis 
 four. If this chain had been composed of fewer 
 bones, they must have either not been capable of 
 bending so much as they do, or have bent more 
 in each joint, which would have pressed the spinal 
 marrow, the ill consequences of which are suffi- 
 ciently seen in persons grown crooked, or who 
 have had distortions from external accidents. 
 
OF THE TRUNK. 
 
 23 
 
 The uppermost vertebrae of the neck being 
 fixed behind the centre of gravity of the head, the 
 neck is therefore so far bent forward as that the 
 last of these vertebrae (which has a firm bearing 
 upon these of the thorax) may be exactly under 
 the centre of gravity. Those of the thorax are 
 bent backwards, behind the centre of motion, to 
 make room for the parts contained in the thorax ; 
 and that they might not be made too weak by the 
 structure, they are formed for less motion than 
 other vertebrae ; and those in particular, which are 
 bent farthest from the centre of gravity have the 
 least motion. The middle vertebrae of the loins 
 are again bent forwards under the centre of grav- 
 ity, or near it ; and from thence they go back- 
 wards to the os sacrum, where being fixed to the 
 ossa innominata behind the centre of gravity, the 
 articulation is therefore firm and without motion, 
 and from thence the ossa innominata are so form- 
 ed, as that their sockets, into which the thigh 
 bones are fixed, where there is a free motion, are 
 exactly under the centre of gravity. In brutes 
 the spine is differently formed, according to the 
 actions for which they are designed. 
 
 In all these vertebrae, except the first, is a mid- 
 dle anterior spongy body, by which they are firm- 
 ly articulated with a very strong intervening liga- 
 ment ; and from the middle of the hind part of 
 each, except the first, stands a process named spi- 
 nalis, and from every one a process on each side.. 
 
24 
 
 OF THE BONEd 
 
 called transversalis, and two superior, and two in- 
 ferior short ones ; by which the back parts of the 
 vertebrae are articulated, named obliqui, superio- 
 res, and inferiores. 
 
 The fore part of the seven vertebrae of the 
 neck, and two upper of the back, are flat for- 
 wards, to make room for the aspera arteria an- 
 gula : the third and fourth of the back acute to 
 give way to the vessels of the lungs and heart, and 
 bent to the right side for the better situation of 
 the heart, which makes that side of the breast 
 more convex than the other, and therefore strong- 
 er ; which seems advantageous to the right arm, 
 its motions depending upon the support it receives 
 from the breast. Hence, I think, it seems, that 
 ( the almost universal preference of that arm is not 
 1 an arbitrary thing, but founded upon observation, 
 that it is capable of more perfect actions than the 
 other. 
 
 The spinal processes of the second, third, fourth, 
 and fifth vertebrae of the neck are forked, the two 
 last long and horizontal, the three or four upper 
 ones of the back like them, only a little declining, 
 the middle ones of the back run obliquely down- 
 wards, and the processes of the remaining vertebrae 
 become successively thicker, stronger, and less de- 
 clining ; those of the loins being horizontal, like 
 the last of the neck. The muscles that are inserted 
 into the spinal processes of the vertebrae of the 
 neck and loins will act with more strength than those. 
 
OF THE TRUNK. 
 
 25 
 
 of the back, because their processes being perpendic- 
 ular to the spine, they are longer levers ; besides, 
 those of the back almost touch one another, to pre- 
 vent much motion, because it would interrupt res- 
 piration ; but more motion being necessary in the 
 neck and loins, their processes are made fit for it. 
 
 The transverse processes of the vertebrae of the 
 neck are perforated, for the admission of the cer- 
 vical blood vessels, and bowed downwards, and 
 hollowed, for the passages of the cervical nerves. 
 The eight or nine upper ones of the back receive 
 the upper ribs ; and the rest, with those of the 
 loins, serve only for origins and insertions of mus- 
 cles. 
 
 Os sacrum has two upper oblique processes, 
 some small spinal processes, and two foramina in 
 each interstice of the bones it is composed of, both 
 before and behind. Ossa coccygis have none of 
 these parts. 
 
 Through every bone of the spine, the ossa 
 coccygis excepted, is a large foramen, which to- 
 gether make a channel through the spine, in which 
 is contained the medulla spinalis ; and in each 
 space between the vertebrae are two large holes for 
 the nerves to pass out. 
 
 It is worth considering the provision which is 
 made to prevent luxations in this chain of bones, 
 such luxations being worse than any other, because 
 of the spinal marrow which is contained within these 
 bones. The bodies of the vertebrae are all in the 
 
26 
 
 o? the bone;; 
 
 same manner connected by strong interveningliga- 
 ments or cartilages. In the neck the oblique pro- 
 cesses of the received bone are wrapped over those 
 of the receiving bone, which forbids their luxating 
 forwards. The transverse processes, with a small 
 apophysis of the body of the same bone, in like 
 manner, secure them from slipping backwards ; 
 and an apophysis on each side of the body of the 
 receiving bone, hinders them from slipping to either 
 side. The vertebrae of the back are hindered from 
 dislocating forwards by the same provision with 
 those of the neck ; and from luxating backwards, 
 by the ribs which are fastened to the transverse pro- 
 cesses of the inferior vertebrae, and against the back 
 part of the body of the next superior : they also 
 ( hinder them from dislocating to either side ; but 
 1 the last ribs are not fixed to the transverse processes 
 of the vertebrae of the back, and therefore it is that 
 luxations are most frequently seen in this part ; but 
 the vertebrae of the loins are received into deep 
 cavities, and are tied with much stronger ligaments 
 for their security. Each joint of the vertebrae, ex- 
 cept the two uppermost, has two centres of mo- 
 tion, one upon the bodies of the vertebrae, when 
 the trunk is bowed forward \ and the other at the 
 articulations of the oblique processes, when the 
 body is bowed backwards ; from which structure 
 the extensors will have about twice the lever to 
 act with, and consequently twice the power to raise 
 the trunk into an erect posture, that they have to 
 
OF THE TR'I/NX. 
 
 27 
 
 carry it beyond that posture : for then the oblique 
 processes begin to be the centre of motion, and give 
 a like advantage to the benders. Without this 
 contrivance it would be more difficult to keep the 
 body erect, or to recover an erect posture with 
 considerable strength after a bend of the body. 
 
 The ribs are twelve in number on each side ; 
 the seven uppermost are called true ribs, because 
 their cartilages reach the sternum ; and the five 
 lowest are called bastard ribs. They are articulated 
 to the bodies of the twelve vertebrae of the back, 
 and all, except the two or three last, are articulat- 
 ed to their transverse processes, and the under 
 side of the middle ribs are hollowed for the passage 
 of the intercostal vessels. They defend the parts 
 contained in the breast, and when they are drawn 
 upwards, the cavity of the breast is enlarged for 
 inspiration, and so the contrary. In two children, 
 which I have dissected, I found the ribs broke in- 
 wards, and on the outside a very plain print of a 
 thumb and fingers, occasioned by their nurses tak- 
 ing hold of their breasts, and hoisting them up on 
 one hand, which being often repeated, had broke 
 the ribs inwards like a green stick, without separat- 
 ing the broken ends of them. I have also very fre- 
 quently seen the shape of children’s breasts quite 
 spoiled by such tricks, which have occasioned weak- 
 ness of body, crookedness, and other diseases. 
 
 Sternum, or breast-bone, is generally made up 
 -of three spongy bones, sometimes more ; to this the 
 
28 
 
 OF THE BONES 
 
 two ribs are articulated by their cartilages, which 
 sometimes in robust men have moveable joints, 
 such as are seen in oxen, and other quadrupeds. 
 At the end of the sternum is the cartilago ensifor- 
 mis, so called from its shape, but it very often is 
 double ; there is also frequently found variety in 
 the form of the cartilages, which join the ribs and 
 sternum; sometimes one cartilage serving two ribs; 
 and sometimes a cartilage not joined to any rib ; 
 frequently in old persons we find parts of them os- 
 sified, and I have twice found them totally ossified 
 .in men between forty and fifty years of age, both 
 of which died with a great difficulty of breathing ; 
 and besides, one had a jaundice, and the other a 
 dropsy, but the lungs in both were very sound. 
 
 There are seldom found fewer than four and 
 twenty vertebra in the spine, besides the os sacrum, 
 but often more ; sometimes thirteen of the back, 
 with as many ribs of a side : and sometimes six in 
 the loins, and in some bodies two ribs from the first 
 vertebra of the loins, but then it has wanted trans- 
 verse processes. 
 
 Os Innominatum is in young persons compos- 
 ed of three bones ; the upper is named ilium, 
 the lower and posterior os ischii, and the anterior 
 os bubis : the upper edge of the ilium is called its 
 spine, the anterior part of the spine its apex, and a 
 little lower is the processes innominatus. Ilium 
 has two processus, the one named the obtuse pro- 
 cess, and the other the acute ; in the centre of 
 
OF THE TRUNK. 
 
 29 
 
 these bones is the acetabulum or socket for the 
 thigh bone ; in the bottom of which socket is an- 
 other cavity, in which lies the lubricating gland of 
 this joint. When impostumations happen in this 
 joint they usually cause a great swelling and lame- 
 ness in the hip, which, in time, makes a collection 
 of matter in the external part of the hip ; how- 
 ever, this is not the only way it proceeds, for I 
 have twice seen the matter in the joint make way 
 through the bottom of the acetabulum into the pel- 
 vis of the abdomen ; in these cases, when the pa- 
 tient went to stool, the matter, by straining, was 
 pressed out through the external wound. 
 
 CHAPTER IV. 
 
 BONES OF THE UPPER LIMB. 
 
 Clavicula is connected at one end to the 
 sternum with a loose cartilage, and at the other 
 to the processus acromion of the scapula ; its 
 chief use is to keep the scapula a sufficient distance 
 from the breast, by which means the shoulders are 
 hindered from coming near together, as they do in 
 those quadrupeds which use their fore limbs only 
 to walk on, and not as men do their hands. 
 
 Scapula is fixed to the sternum by the clavi- 
 cula, but its chief connection is to the ribs and 
 
50 
 
 BONES OF THE 
 
 spine, by those muscles which are made also for its 
 various motions ; and in such quadrupeds as have 
 no clavicles it is fixed only by muscles, whose 
 actions give to this bone a great deal of that mo- 
 tion which seems to be in the joint of the shoulder. 
 The under side of this bone is a little concave, 
 partly to fit to the outer surface of the ribs on 
 which it moves, and partly to give room for the 
 sub-scapularis muscle. On the outside arises a 
 large spine ; the fore part of which is called the 
 processus acromion, to which the clavicula is fixed. 
 In men and such quadrupeds as have clavicles, and 
 use their fore limbs like arms, this process and 
 spine are much larger and more prominent, not 
 only for the better fixing the clavicle, but also to 
 ( remove the muscles farther from the centre of 
 
 c motion, whereby they are able to move a greater 
 
 weight. Near this process is another called cora- 
 coides, from whose extremity, with like advan- 
 tage, arise two muscles of the arm ; this process 
 with the former and a flat ligament between them 
 both, hinder the os humeri from being dislocated 
 upwards. The side opposite to the socket is called 
 the basis of the scapula, and the lower edge costa 
 inferior from its figure, which is thick, and like a 
 rib to the scapula ; but its upper edge being very 
 thin, is improperly so called in the human skele- 
 ton, though not so in many quadrupeds. At the 
 fore part of this edge, close to the coracoid pro- 
 cess, is a semicircular nich for the passage of blood 
 
UPPER. LIMB. 
 
 31 
 
 vessels, which nich is joined at top with a liga- 
 ment, and sometimes with bone. 
 
 Os humeri : its upper end or head, where it is 
 joined to the scapula, is somewhat flat, and much 
 larger than the socket which receives it. At the 
 upper part are two processes for the insertions of 
 muscles of the arms ; between these processes is a 
 long channel, in which lies a tendon of the biceps 
 cubiti. At the lower end are two considerable 
 processes, both formed to give origins to muscles 
 of the wrist and fingers ; and the flexors of these 
 joints being much more considerable than the ex- 
 tensors, the inner process from which the flexors 
 arise is therefore much larger than the outer, from 
 which the extensors take their origins : between 
 these processes is the joint. That part to which 
 the upper end of the radius is fixed, is fitted not 
 only for the motion of the elbow, but also for the 
 rotatory motion of the radius ; the rest of this 
 joint is made of portions of unequal, but concen- 
 tric circles, like the shanks of quadrupeds ; which 
 inequality prevents the ulna from dislocating side- 
 ways, which so small a joint with so much motion 
 would be very subject to. Of a like use is the little 
 sinus on the fore part of the humerus, and the large 
 one behind ; the first of which receives a process 
 of the ulna when the arm is bent, and the other, 
 the olecranon, when the arm is extended. 
 
 Ulna : at the upper end it has one large pro- 
 cess called olecranon, and a small process on the 
 
52 
 
 BONES OF THE 
 
 fore part ; and on one side between these is also 
 a small cavity which receives the upper end of 
 the radius for its rotatory motion ; and down the 
 side of this bone, next the radius, is a sharp edge, 
 from which the ligament arises, which connects 
 those bones together. At the lower end is a pro- 
 cess, called styliformis, and a round head, which is 
 received into the radius for the rotatory motion 
 of the cubit. 
 
 Radius : its upper end is received into the ulna, 
 and joined to the humerus, in a manner chiefly fit- 
 ted for its rotatory motion, for the strength of the 
 elbow joint receives but little advantage from the 
 union of these two bones. A little below this 
 head is a large tubercle, into which the biceps 
 muscle is inserted, which by the advantage of this 
 insertion turns the cubit supine, as well as bends 
 it. At the lower end, which is thicker, is a socket 
 to receive the carpus, and at the side next the ulna 
 a small one to receive that bone, and a thin edge,, 
 into which the transverse ligament, which arises 
 from the ulna, is inserted. This ligament ties 
 these bones conveniently and firmly together : for 
 the ulna being chiefly articulated to the os hume- 
 ri, and the radius to the carpus, a weight at the 
 hand, without this ligament, would be liable to 
 pull these bones asunder. 
 
 Of the bones of the hand : Carpus is composed 
 of eight bones of very irregular forms, undoubted- 
 ly the properest that can be ; yet why in these 
 
UPPER LIMB. 
 
 33 
 
 forms, rather than any other, no one has been 
 able to shew. They have all obscure motions one 
 with another, and with those of the metacarpus ; 
 but the motion of those of the first rank, or or- 
 der, with those of the second is more considerable, 
 and are moved by the same muscles which move 
 the carpus on the radius. The metacarpus con- 
 sists of four bones which sustain the fingers ; that 
 of the fore finger having the least motion, and 
 that of the little one the most : the other ends of 
 these bones have round heads for the articulations 
 of the fingers but the other joints of the fingers 
 double heads and sockets. The thumb is shorter 
 and stronger than any of the fingers, because in 
 its actions it is to resist them all. The first joint 
 is very singular, each bone receiving and being 
 equally received. The bones of the fingers on 
 the inside are flat and a little hollow, which is nec- 
 essary to make room for the flexors of the fingers, 
 and to render their shape proper for grasping ; 
 but this lessening their diameters, and consequent- 
 ly weakening them in the direction in which they 
 are most liable to be broke, such inconvenience is 
 provided against by a larger substance. 
 
34 
 
 BONES OF THE 
 
 CHAPTER V. 
 
 BONES OF THE LOWER LIMB. 
 
 Os Femoris at its upper end has a round head 
 which is received into the socket of the os in- 
 nominatum. In most quadrupeds this head is ob- 
 long, and makes a firmer articulation ; but that 
 shape will not allow of so much motion as a round- 
 er head. The two processes near the head are call- 
 ed the greater and lesser trochanters, which are 
 evidently formed for the insertion of muscles, as 
 the neck which lies between these and the head, is 
 formed to make room for that necessary quantity 
 of muscles which are seated on the inside of the 
 thigh, and also by projecting outwards to make 
 long levers for the muscles, which are inserted 
 into its upper and external parts. Between the 
 great trochanter and the neck is a large sinus, into 
 which muscles are inserted : between the two tro- 
 chanters is a remarkable roughness for the same use, 
 from which begins the linea aspera. The middle 
 of this bone, for the conveniency of the muscles, 
 is bent forwards, which would make it subject to 
 break backwards, if there was not a strong ridge 
 on the back side, which strengthens it sufficiently, 
 and serves also for advantageous insertions for sev- 
 eral muscles ; this ridge is called the linea aspera. 
 At the lower end of this bone are two large heads. 
 
LOWER LIMB. 
 
 called the outer and inner apophyses : these are so 
 contrived, partly from being projected backwards, 
 and partly from their shapes, as to remove the cen- 
 tre of motion very far behind the axis of the bone, 
 which gives great power to the muscles that ex- 
 tend this joint to raise the whole weight of the 
 body, though it lessens the power of the benders 
 which move the leg only ; between these pro- 
 cesses the large vessels descend securely to the leg. 
 
 Patella is seated on the fore part of the knee ; 
 its first appearance is in the centre of the tendon, 
 through which it soon extends, until the tendinous 
 fibres are lost, and appear to be converted into 
 bone ; however, when this bone is broke, the orig- 
 inal tendinous fibres seem to prevail, seeing the 
 broken parts, unlike all other bones when frac- 
 tured, unite with a tendon-like substance, which 
 is rarely converted into bone, and especially in 
 those cases where the joint recovers with most 
 motion ; its use is to secure the extensors of the 
 tibia, lest, passing over the joint, they might be 
 too much exposed to external injuries ; it also in- 
 creases the advantage (mentioned in the last para- 
 graph) of removing the common axis of the exten- 
 sors of the tibia farther from the centre of motion, 
 and is a most convenient medium for those mus- 
 cles to unite in, to perform one common action. 
 
 Tibia, the shin bone, is large at its upper end, 
 where are too shallow sockets which receive the 
 thigh bone ; between these is a rough process, to 
 
36 
 
 BONES OF THE 
 
 which the cross ligaments of this joint are con- 
 nected. Near the upper end is a process, inta 
 which the ligament or tendon of the patella is in- 
 serted, and at the lower end is the process, which 
 makes the inner ancle, and secures this bone from 
 dislocating outwards. Towards the upper end 
 this bone is triangular, and even concave on the 
 side next the muscles to make room for them ; 
 but lower, as the muscles grow less and tendinous, 
 the bone grows rounder ; that being upon the 
 whole a stronger form yet it is not made so 
 strong as the thigh bone, though it bears a greater 
 weight, which it is able to dp by being straighter, 
 shorter, and bearing the weight of the body in a 
 more perpendicular direction. 
 
 Fibula is seated on the outside of the tibia ; 
 its upper end is joined to that bone below the joint 
 of the knee, and its lower end is received into a 
 shallow sinus of the same bone, and below that 
 makes the external ancle ; which process, with the 
 process of the tibia, strengthens the ancle joint, 
 which nevertheless, being so small, would have 
 been not strong enough, if it had. been made for 
 more motion. It is doubtful to me, whether or 
 not this bone contributes to the support of the 
 body ; but its great use is for the origins of mus- 
 cles, and even its shape is suited to theirs. 
 
 Of tire bones of the foot : Tarsus is composed 
 of seven bones, the first of which, called astraga- 
 lus, supports the tibia, and is supported by the oa 
 
LOWER LIMB. 
 
 37 
 
 adds, which being projected backwards, makes a 
 long lever for the muscles to act with, that extend 
 the ancle and raise the body upon the toes. These 
 two bones have a considerable motion between 
 themselves, and the astragalus also with the os na- 
 viculare, and all the rest an obscure motion one 
 with another, and with the bones of the metatarsus, 
 the greatest part of these motions being towards 
 the great toe, where is the greatest stress of action: 
 these bones thus giving way are less liable to be 
 broke, and, as a spring under the leg, make the mo- 
 tions of the body in walking more easy and grace- 
 ful, and the bones which are supported by them 
 less subject to be fractured in violent actions. To 
 these join five others, called the metatarsal bones ; 
 that which supports the great toe is much the larg- 
 est, there being the greatest stress in walking j 
 under the end of this lie the two sesamoid bones, 
 which are of the same use as the patella the great 
 toe has two bones, the lesser three each, the two 
 last of the least toes frequently grow together. 
 
 Children are sometimes born with their feet 
 turned inwards, so that the bottom of the foot is 
 upwards : in this case the bones of the tarsus, like 
 the vertebrae of the back in crooked persons, are 
 fashioned to the deformity. The first knowledge 
 I had of a cure of this disease was from Mr. Pres- 
 grove, a professed bone-setter, then living in 
 Westminster. I recommended the patient to him, 
 not knowing how to cure him myself. His way was 
 
38 
 
 BONKS OF THE 
 
 by holding the foot as near the natural posture as 
 he could, and then rolling it up with straps of 
 sticking plaster, which he repeated from time to 
 time, as he saw occasion, until the limb was re- 
 stored to a natural position, but not without some 
 imperfection, the bandage wasting the leg, and 
 making the top of the foot swell and grow larger. 
 After this, having another case of this kind under 
 my care, I thought of a much better bandage, 
 which I had learnt from Mr. Cowper, a bone-set- 
 ter at Leicester, who set and cured a fracture of my 
 own cubit when I was a boy at school. His way 
 was, after putting the limb in a proper posture, to 
 wrap it up in rags dipped in the whites of eggs, 
 and a little wheat flower mixed j this drying, grew 
 stiff, and kept the limb in a good posture. And I 
 c think there is no way better than this in fractures, 
 for it preserves the position of the limb without 
 strict bandage, which is the common cause of 
 mischief in fractures. When I used this method 
 to the crooked foot, I wrapt up the limb almost 
 from the knee to the toes, and caused the limb to 
 be held in the best posture till the bandage grew 
 stiff, and repeated the bandage once a fortnight. 
 
 The bones are subject to diseases from all the 
 same causes that the other parts are, but either from 
 their hardness, insensibility, or other causes, they 
 neither are so frequently diseased, nor do their dis- 
 eases appear so various ; and it is generally of more 
 consequence what texture the diseased bone, or part 
 
LOWER LIMB. 
 
 39 
 
 of the hone is of, than from what cause that disease 
 proceeded ; for when diseases happen upon the 
 surfaces of the hard bones, they usually admit a 
 cure by exfoliation ; but when matter is made in 
 the spongy ends of the cylindrical bones, or in the 
 bodies of other spongy bones, the matter, what- 
 ever was the first cause, insinuates itself through 
 those spongy cells, swelling the bone, and making 
 generally an incurable caries ; but if the matter is 
 corrosive, it often ulcerates these parts ; and usu- 
 ally makes so large a discharge as to destroy the 
 patient where the part diseased cannot be extir- 
 pated, which is often the case when matter is 
 made in the bones in scrophulous habits. 
 
 The venereal disease rarely attacks any but the 
 hardest parts of the bones, very soon raising large 
 tumours and caries or mortification ; but these ca- 
 rious parts of bones from this or other causes are 
 but partially mortified ; for, were they perfectly 
 so, the sound and unsound parts would separate, 
 though the integuments were not taken off ; 
 whence it happens, that, where there is a good hab- 
 it of body, carious bones are often endured many 
 years without much inconvenience ; and we find 
 from experience, that such separations are not to be 
 made till the diseased part is laid bare and perfectly 
 mortified by being exposed to the air, &c. and then 
 the sound part underneath separating from the un- 
 sound, there first granulates a fungous flesh-like ap- 
 pearance, which ought never to be treated with cor- 
 
40 
 
 BONES OF THE 
 
 rosive medicines, it constantly shrinking and harden- 
 ing of itself, being the same substance which shoots 
 from the ends of broken bones, where also it soon 
 shrinks and converts into a callus to reunite them. 
 
 There is a caries distinct from these, which I 
 have only seen in two patients who died after a 
 long rheumatic disorder, in which the outer sur- 
 face of all the hardest bones, as the middle of the 
 cylindrical bones, and the top of the scull, in one 
 which I boiled, and in the other as far as I was 
 .allowed to examine, I found the outer part every 
 where crumbly or scaly, falling into pieces like 
 dust or sand, with very little appearance of tumour 
 any where, and no appearance of disease in the 
 spongy parts. 
 
 Sometimes matter is formed in the large me- 
 dullary cavities of the cylindrical bones, which con- 
 stantly increasing and wanting vent, partly by cor- 
 roding and rendering the bone carious, and partly 
 by pressure, tear asunder the strongest bone in an 
 human body, of which I have known several in- 
 stances. In one case where the matter had suffic- 
 ient discharge by an external caries formed together 
 with the internal one, all the internal hard part of 
 the bone which contains the medulla was separated 
 from the rest ; and being drawn out through the 
 place where the external caries made a vent, the pa- 
 tient received a perfect cure. In another case of 
 this kind, where the internal part which contains 
 the medulla was also separated from the reft, and 
 
LOWER LIMB. 
 
 41 
 
 there beingholes through which the matter was dis - 
 charged,but none sufficient to take out the exfoliat- 
 ed bone ; the matter continued to flow in great quan- 
 tity till it destroyed the patient ; and possibly, if 
 this case had been rightly known, the internal ex- 
 foliated part might have been taken out, and the 
 patient cured. In both these cases, it seems as if 
 only so much of the internal part of the bone was 
 become carious, as receives nourishment from the 
 artery which enters the middle of the bone ; and as 
 a caries is a mortification of a bone, might not this 
 disease arise from a hurt in the vessel which nour- 
 ishes that particular part ? 
 
 CHAPTER VI. 
 
 CARTILAGES, LIGAMENTS, &C. 
 
 Evert part of a bone which is articulated to 
 another bone for motion, is covered or lined with 
 a cartilage, as far as it moves upon, or is moved 
 upon by another bone in any action ; for carti- 
 lage being smoother and softer than bone, it ren- 
 ders the motions more easy than they would have 
 been, and prevents the bones wearing each other 
 in their actions. 
 
 In each articulation of the lower jaw, there is a 
 loose cartilage, upon which the condyloid process 
 moves on one side, while the jaw is moved to the 
 
42 
 
 CARTILAGES, 
 
 other; and the two processes being thus raised at 
 once ; the jaw is thrust forward. These cartilages 
 are also found in animals that chew the cud, but 
 not in beasts of prey, as far as I have examined, 
 their articulations being also deeper and firmer ; and 
 in the otter particularly, sections of the sockets, 
 which receive the condyloid processes of the lower 
 jaw, are more than half circles ; so that the jaw 
 cannot be dislocated directly without breaking the 
 sockets. This structure renders the motions of the 
 jaw more firm, as that with intervening cartilages 
 makes it more loose and voluble. There are also 
 cartilages of this kind between the clavicles and 
 the sternum. 
 
 In the joint of the knee are two loose, almost 
 annular cartilages, which being. thick at their outer 
 edges, and thin at their inner ones, they make the 
 greatest parts of the two sockets in this joint. The 
 use of these cartilages is to make variable sockets to. 
 suit the different parts of the lower end of the os 
 femoris ; for none but a round head and a round 
 cavity can suit in motion, unless the shape of one 
 or the other alters : and it is plainly necessary, that 
 thisdower end of the os femoris should be flattish, 
 and projected backward, to give advantage to the 
 muscles that extend the tibia, by setting the centre 
 of motion backward : which mechanism, though 
 It equally lessens the power of those muscles which 
 bend this joint, is yet of great service, because the 
 extendingmuscles move this joint under the weighs 
 
43 
 
 LIGAMENTS, &C. 
 
 ©f the whole body, but the flexors only raise the 
 legs ; and as no head or socket moves so easily as 
 round ones, here seems to be some provision made 
 against the inconvenience of a flattish head and cav- 
 ity, by having the friction made upon two surfaces, 
 the os femoris upon the loose cartilages, and the 
 loose cartilages upon the tibia. This contrivance 
 is practised by mechanics, where the friction of^ 
 the joints of any of their machines is great, as be- 
 tween the parts of hook-hinges of heavy gates, 
 and between the male and female screws of large 
 vices, where they usually place a loose ring. 
 
 There are other cartilages which serve to give 
 shape to parts. Of this sort are the ciliary cartil- 
 ages at the edge of the eye-lids, the cartilages of 
 the outer ears, and those which compose the low- 
 er part of the nose, which have this particular ad- 
 vantage in these places, that they support and 
 shape the parts as well as bones do, and without 
 being liable to be broke ; and to these might be 
 added those of the larynx, but they do not belong 
 properly to the skeleton. 
 
 Bones that are articulated for motion are tied 
 together by very strong ligaments, to prevent 
 their dislocating, which also surround the joints 
 to contain their lubricating mucus. The thick- 
 ness and strength of these ligaments are propor- 
 tioned to the actions of the several joints, and 
 their lengths are no more than sufficient to allow 
 ^ proper quantity of motion ; but the forms of 
 
44 
 
 CARTILAGES, 
 
 them are different according to the different ac- 
 tions of the several joints. 
 
 The bones of the limbs that move to all sides 
 have ligaments like purses, which arise from or 
 near the edges of the sockets of the receiving bones, 
 and are inserted all round the received bones a little 
 below their heads. The beginnings of these liga- 
 ments, from the edges of the sockets of the scapula 
 and os innominatum, are very hard, almost cartila- 
 ginous, which serves in the scapula to make a larg- 
 er socket, and such an one as will alter the figure 
 as the bone moves, for the reason I have mentioned 
 in the loose cartilage of the knee : for the head of 
 theos humeri, not being an exact portion of a sphere, 
 requires such a socket, and the hard part of this lig- 
 ament of the socket of the os innominatum, makes 
 the socket deeper than the semidiameter of the 
 socket, by which means the articulation is made 
 stronger without any hindrance to motion, because 
 it will give way to the neck of the os femoris when 
 it presses against it ; and the thigh bone being more 
 disposed to be dislocated upwards than any other 
 way, the upper side of this burfal ligament is made 
 exceeding flrong to prevent fuchan accident. From 
 the lower edsre of the acetabulum or focket of the 
 
 O 
 
 os innominatum arifes a ligament about an inch 
 long, called teres, or rotundum, which length is 
 necessary for that quantity of motion which this 
 joint has in human bodies ; it also hinders the os 
 femoris from dislocating upwards, but downwards 
 
45 
 
 LIGAMENTS, &C, 
 
 it will suffer it to go far out of the socket ; but in 
 brutes the head of the os femoris being oblong, 
 and the cavity suitable, there can be only a rota- 
 tory motion, which in effect will be very little 
 more than that kind of motion which is called 
 bending and extending ; and this never removing 
 the end of the head of the bone far in the socket, 
 a short ligament is enough for it, and will better 
 keep the bone in its place ; and therefore it is that 
 theirs is so short. This ligament in men may also 
 serve to press the gland in the bottom of the aceta- 
 bulum or socket. 
 
 The ligaments of those joints which admit only 
 .of flexion and extension, differ from the former 
 in this, that they are much shorter and stronger at 
 the sides of the joints, and thinner backward and 
 .forward. Besides these ligaments, in the middle 
 and back part of the joint of the knee, are two very 
 strong ligaments, which arise from a process at the 
 end of the tibia. They cross each other in such a 
 manner, as is best to secure the joint from being 
 displaced any way ; they also hinder the extensors 
 of the tibia from pulling that bone too far for- 
 wards, and are so connected to the semilunar carti- 
 lages, as to move them as the joint moves ; be- 
 sides these, in this joint is another small one, which 
 arises from the os femoris, and ends in the fatty 
 membrane which it supports. The knee, I think, 
 cannot be completely dislocated without breaking 
 jthe cross ligaments : I have seen this case but once, 
 
46 
 
 CARTILAGES, 
 
 the bone indeed was easily restored to its place, 
 but to no purpose. 
 
 The bones of the carpus and tarsus are tied to- 
 gether by ligaments running promiscuously upon 
 their surfaces from one to another 5 which at the 
 under side of the tarsus are vastly strong, because 
 they support the whole body ; these ligaments to- 
 gether contain the mucus forall those joints. There 
 is also to the carpus a strong ligament, which runs 
 from the fifth bone to the eighth, and the process 
 of the fourth bone : the proper use of this is, to 
 bind down the tendons of the muscles that bend 
 the fingers. 
 
 The processus dentanus of the second vertebra is 
 tied to the scull by a ligament, and kept close to 
 the forepart of the first vertebra by another in that 
 vertebra, that it may not bruise the spinal mar- 
 row ; and when either this ligament or process is 
 broke, it makes that sort of broken neck which is 
 attended with sudden death. All the bones of the 
 vertebrae, and every joint that is without motion, 
 and not joined by a suture, as the ossa innominata 
 with each other, and the os sacrum with the ossa 
 innominata, are joined by intervening ligaments, 
 or, as they are commonly called, cartilages. The 
 ossa innominata are also tied by very strong liga- 
 ments which run from the back parts of the spines 
 of the ossa ilia to the os sacrum, and other liga- 
 ments which go from the os sacrum, and os coccy- 
 gis to the acute and obtuse processes of the ossa is- 
 
LIGAMENTS, &C. 4.7 
 
 chia : these ligaments serve also for origins of mus- 
 cles. Towards the great foramen of the ossa inno- 
 minata the acetabulum has a deep notch, from the 
 one side to the other of which runs a ligament 
 which completes the socket ; this ligament is some- 
 time ossified : a ligament somewhat like this there 
 is between the processes of the scapula. 
 
 From the edge of the ilium to that of the os 
 pubis, runs a ligament which is contiguous to, 
 and appears to be a part of, the tendons of the mus- 
 cles of the abdomen ; its use is to cover the iliac 
 vessels as they descend to the thigh. Under this 
 ligament, together with the vessels, I have often 
 seen a rupture of matter, and, I think, sometimes 
 of the gut, from the abdomen into the anterior 
 part of the thigh, immediately below the groin : 
 however, I dare affirm this to be a possible case. 
 
 It is generally agreed, that the ligaments are in- 
 sensible, and the reason assigned is, that they would 
 else be injured by ordinary motions. But they are 
 much better contrived ; seeing none of them, not 
 even those which lie between the vertebrae, are sub- 
 ject to attrition ; but the other, experience shews, 
 are capable of very acute pains ; there being not 
 any thing ourpatients more grievously complain of, 
 than collections of matter within these parts, or 
 sharp medicines applied to them, when laid bare. 
 
 Every joint, where the bones are faced with a 
 cartilage for a sliding motion, is furnished with 
 small glands, which separate a mucilaginous mat- 
 
48 
 
 CARTILAGES, 
 
 ter for the lubricating of the ends of the bones, that: 
 they may move easily upon one another ; and that 
 there may be no waste of this necessary fluid, it is 
 contained in the investing ligaments ; which for 
 this very reason, are no where divided, except to 
 communicate with the ligaments of the tendons. 
 
 These glands are generally seated in a little fat 
 near the insertion of the ligaments, that they may 
 be compressed by them when the joints are in mo- 
 tion ; which is a proper time to have their fluid 
 pressed out. The most considerable parcel of these 
 glands, with their fat, are seen in the joint of the 
 knee, and the largest gland of this sort is found in 
 the sinus at the bottom of the acetabulum of the 
 os innominatum, and is compressed by the liga- 
 mentum teres. 
 
 The diseases of the joints either happen from 
 ulcers in the lubricating glands, which, pouring out 
 matter that cannot be discharged, foul the ends 
 of the bones, or else from swellings in the ends of 
 the respective bones. Either of these in time create 
 excessive pain, which appears to me to be chiefly 
 irtthe ligamentsof the joints, notwithstanding what 
 has been said of the insensibility of these parts. 
 When a joint is much swelled and painful, with- 
 out external inflammation, it is vulgarly called a 
 white swelling, and more properly so than spina 
 ventosa. It is sometimes in the beginning cured 
 by evacuations, but when the limb wastes below 
 the swelling, and the fingers or toes of the limb 
 
49 
 
 LIGAMENTS, &C. 
 
 grow thinner at their joints, and lose their shape, 
 the case then is absolutely irrecoverable. Some- 
 times the ends of the bones erode, then join togeth- 
 er and form an anchylosis, which, though a severe 
 disease of itself, yet it is often a remedy of one that 
 is much worse. In like manner the bones of the 
 hands and feet, when they are ulcerated, sometimes 
 unite, and are thus preserved from total ruin. But 
 there is one case of a white swelling that is amazing, 
 where the pain is so great that we are forced to 
 take off the limb, and yet neither find upon dissec- 
 tion the ligaments or glands diseased, nor matter in 
 the joint, nor the bones carious, or any diseased ap- 
 pearance, except that the ends of the bones are a lit- 
 tle larger and softer. * 
 
 j 
 
 >■■■ % 
 
 H 
 
50 
 
 TABLES. 
 
 TABLE I. 
 
 A, The skeleton of a child twenty months old, in 
 which all the bones differ in shape from those 
 of an adult. The scull is much larger in pro- 
 portion, and the bones of the limbs without 
 those roughnesses and unevennesses which af- 
 terwards appear ; their texture is every where 
 more loose and spongy, and their outlines what 
 the painters call tame and insipid ; their ex- 
 tremities are separate and formed cartilaginous, 
 which is accurately distinguished in the plates 
 by the manner of graving. 
 
 B, The thigh bone of a man, sawed through, in the 
 middle of which is seen the cavity which con- 
 tains the oily marrow, and at the extremities the 
 lesser cells, which contain the bloody marrow. 
 The white line across the head of this bone, be- 
 ginning at the fingers of the skeleton, is the 
 place where the epiphysis and the bone are unit- 
 ed. A like line, across the lower end of this 
 bone, shews there the same thing. 
 
 G, The os bregmatis of a foetus six months old, 
 which shews the fibres ossifying from the centre 
 to the circumference. 
 

 T^B.I 
 
 J>. So 
 

 
 
 
 
 
 
 
 
 
 c 
 
 
 
 
 
 
 
 ' 
 
 
 
 
/ 
 
 /* 
 
 
 
 
 . 
 
 
 
 
 
 
 
 
) 
 
TABLES. 
 
 TABLE II. 
 
 1 Os frontis. 
 
 2 Os bregmatis. 
 
 3 Os temporis. 
 
 4 Os occipitis. 
 
 5 Os malse. 
 
 6 Os maxillae superior is. 
 
 7 Os nasi. 
 
 8 Os planum. 
 
 9 Processus mastoideus. 
 
 10 Processus styloides. 
 
 1 1 Processus pterygoides. 
 
 12 Dentes. 
 
 13 Processus coronalis. 
 
 14 Processus condyloides. 
 
 15 Dentes. 
 
52 
 
 TABLES. 
 
 TABLE III. 
 
 1 Os frontis. 
 
 2 Os bregmatis. 
 
 3 Os occipiti?. 
 
 4 S'eila turcica. 
 
 5 A process of the os sphenoides, making part of 
 
 the septum nasi. 
 
 6 A process of the os ethmoides, making part of 
 
 the septum nasi. 
 
 7 Vomer. 
 
 8 Crista galli, before which is seen in shadow the 
 
 sinus frontalis. 
 
 9 The cornua of the os sphenoides. 
 
 10 Sella turcica. 
 
 11 Os frontis. 
 
 12 Crista galli and os ethmoides. 
 
 13 Sinus frontales, 
 
 1 4 Sella turcica. 
 
 1 5 The fifth foramen. 
 
 16 Processus jugales. 
 
 17 Os petrosum. 
 
 18 Foramen magnum. 
 
 19 The outside of the os occipitis. 
 
TARDJ. 
 

 
 
 
P.53. 
 
TABLES. 
 
 S3 
 
 TABLE IV. * 
 
 1 The second vertebra of the neck. 
 
 2 The transverse processes of the vertebrae of the 
 
 neck. 
 
 3 Clavicula. 
 
 4 The processus acromion of the scapula. 
 
 5 Os humeri. 
 
 6 The ribs. 
 
 7 The transverse processes of the vertebrae of the 
 
 loins. 
 
 8 The os sacrum and os coccygis. 
 
 9 Os ilium. 
 
 10 Os ischium. 
 
 11 Os pubis. 
 
 12 Os femoris. 
 
 t 
 
54 
 
 tables. 
 
 > TABLE V. 
 
 1 The under side of the first vertebra of the neck. 
 
 2 A side view of the second vertebra. 
 
 3 The processus dentatus of the second vertebra. 
 
 4 The under side of the oblique process. 
 
 5 The spinal process. 
 
 6 The under side of the body of the seventh ver- 
 
 tebra of the neck. 
 
 7 The transverse processes. 
 
 8 The oblique processes. 
 
 9 The spinal process. 
 
 10 The spinal process of the second vertebra of the 
 
 back. 
 
 1 1 The under and fore side of the body of the ver- 
 
 tebra. 
 
 12 The transverse processes. 
 
 13 The upper oblique processes of the third verte- 
 
 bra of the back. 
 
 14 The transverse processes, 
 
 15 The spinal process. 
 
 16 The body of the third vertebra of the loins,' 
 
 17 The transverse processes. 
 
 18 The upper oblique processes. 
 
 19 The spinal process. 
 

 TAB .V, 
 
 T.3'4 
 

TAB VI. 
 
 P.S5 
 
TABLES. 
 
 55 
 
 TABLE VL 
 
 1 The head of the os humeri. 
 
 2 The outer extuberance. 
 
 3 The inner extuberance. 
 
 4 That part which joins with the ulna. 
 
 5 The olecranon of the ulna. 
 
 6 The lower end of the ulna which joins to the 
 
 radius. 
 
 7 Processus styloides. 
 
 8 The upper end of the radius. 
 
 9 The tubercle. 
 
 10 The part of the radius which joins with the 
 carpus. 
 
 11, 12, 13, 14, 15, 16, 17, IP, The eight bones • 
 of the carpus. 
 
56 
 
 TABLES. 
 
 TABLE VIL 
 
 1 Radius. 
 
 2 Ulna. 
 
 3 Carpus. 
 
 4 The three bones of the thumb. 
 
 5 The four bones of the metacarpus 
 
 6 The three bones of the fingers. 
 
 c . 
 
 k 
 

 
 T AS Vir. 
 
 P.56 
 
 * 
 
 : 
 

TAB.VUf. 
 
TABLES, 
 
 57 
 
 TABLE VIII. 
 
 1 The head of the os femoris. 
 
 2 The great trochanter, 
 
 3 The lesser trochanter. 
 
 4 The lower end which articulates with the tibia, 
 
 5 The upper end of the tibia. 
 
 6 The lower end of the tibia. 
 
 7 The process which makes the inner ancle. 
 
 8 The upper end of the fibula. 
 
 9 The lower end which makes the outer ancle, 
 
 10 The outside of the patella, 
 
 1 1 The inside of the patella, 
 
 » 
 
 i 
 
TABLES. 
 
 58 
 
 TABLE IXT 
 
 1 Astragalus. 
 
 2 Os calcis. 
 
 3 Os naviculare. 
 
 4, 5, 6, Ossa cuneiformia. 
 
 7 Os cuboides. 
 
 8 The five bones of the metatarsus. 
 
 9 The two bones of the great toe. 
 
 10 The three bones of the lesser toes. 
 

 

 . 
 

 TAB.X. 
 
 ( 
 
 < , 
 
TABLES. 
 
 59 
 
 TABLE X, 
 
 A skeleton of an adult put into this posture to 
 shew it in a greater scale. It was thought better 
 not to figure it, all these bones being explained in 
 former plates, and the design of this being to shew 
 them together, without being defaced with refer- 
 ences. 
 
 J 
 
THE 
 
 ANATOMY 
 
 OF THE 
 
 HUMAN BODY. 
 
 BOOK II. 
 
 CHAPTER L 
 
 INTRODUCTION TO THE MUSCLES. 
 
 The muscles are moving powers, applied to per- 
 form the several motions of the body ; which they • 
 do by contracting their length, and thereby bring- 
 ing the parts to which they are fixed nearer togeth- 
 er. The immoveable or least moved part any 
 muscle is fixed to, is usually called its origin, and 
 the other its insertion ; but muscles that have their 
 two ends equally liable to be moved, may have ei- 
 ther called the origins or insertions. 
 
 Each muscle is made up of a number of small 
 fibres, which Borelli and others have thought 
 
6 -2 
 
 INTRODUCTION 
 
 to be strings of bladders, and have endeavoured to 
 account for muscular motion by an expansion made 
 from an influx of blood and animal spirits into these 
 bladders ; but as the muscles do not increase their 
 bulk sensibly in contracting, there needs no more 
 to be said to refute this hypothesis. But another 
 great author thought that in this way the muscles 
 might be contracted by a swelling, scarce sensible, 
 if the bladders were but very small : for, says he, 
 supposing a bladder of any determined bigness cs|n 
 raise a weight a. foot, a hundred bladders, whose 
 diameters are each a hundredth part of the former, 
 will raise the weight to the same height. But the 
 force of inflation and the swelling of all together 
 will be ten thousand times less, and it will also 
 raise ten thousand times less weight, which he 
 has not observed ; therefore not one such string of 
 bladders, but ten thousand, must be applied to do 
 the same thing that the one bladder will do ; and 
 they will have the same swelling ; otherwise it 
 would be easy to shew how to make a pcrpetuum 
 mobile of almost any force. 
 
 The muscles are of two sorts, viz. rectilineal, 
 and penniform. The former have their fibres al- 
 most parallel, in the same or near the same direction 
 with the axis of the muscle ; and the latter have 
 their fibres joined, in an oblique direction, to a ten- 
 don passing in or near the axis, or on their outside. 
 
 The rectilineal muscles, if their origins and in- 
 sertions are in little compass, are never of any con- 
 
TO THE MUSCLES. 
 
 t* o 
 
 63 
 
 siderable thickness, unless they are very long, be- 
 cause the outer fibres would compress the inner 
 ones, and make them almost useless ; and therefore 
 every rectilineal muscle, whose inner fibres are 
 compressed by the outer, have their inner fibres 
 longer than the external, that they may be capable 
 of equal quantity of contraction. 
 
 The penniform muscles, though they are in a 
 manner free from the inconvenience of one fibre 
 compressing another, and though by the obliquity 
 of their fibres, nothing is abated of their moment, 
 (for in all cases, just so much more weight as recti- 
 lineal fibres will raise than oblique ones, the ob- 
 lique will move their weight with so much greater 
 velocity than the rectilineal ; which is making their 
 moments equal : so that in the structure of an ani- 
 mal, like all mechanic engines, whatever is gained 
 in strength is lost in velocity, and whatever is gain- 
 ed in velocity is lost in strength) yet the fibres of 
 the penniform muscles becoming more and more 
 oblique as they contract, their strength decreases, 
 and their velocity increases, which makes them less 
 uniform in their actions than the rectilineal mus- 
 cles ; wherefore it seems that nature never uses a 
 penniform muscle where a rectilineal muscle can 
 be used ; and the cases in which* a rectilineal mus- 
 cle cannot be used, are where the shape of a mus- 
 cle is such as that the inward fibres would be too 
 much compressed, or where rectilineal fibres could 
 
64 
 
 INTRODUCTION* 
 
 not have a lever to act with, suitable to their quan- 
 tity of contraction, which is the case of all the 
 long muscles of the fingers and toes. For every 
 muscle must be inserted or pass over the centre 
 of motion of the joint it moves, at a distance, 
 suitable to its quantity of contraction, and the 
 quantity of motion in the joint moved ; for if it 
 was inserted too near, then the motion of the joint 
 would be performed before the muscle is contract- 
 ed all that it can ; if too far off, the muscle will 
 have done contracting before the whole motion of 
 the joint is made. And though the quickness and 
 quantity of mot-ion in a muscle will be, cseteris pa- 
 ribus, as the length of its fibres ; (for if a fibre four 
 inches long will contract one inch in a given time, 
 a fibre eight inches long will contract two inches 
 in the same time ; and the strength of a muscle 
 or power to raise a weight, cseteris paribus, will 
 be as the number of its fibres ; for if one fibre 
 will raise a grain weight, twenty fibres will raise 
 twenty grains :) nevertheless, two muscles of 
 equal magnitude, one long, and the other short, 
 will both move the same weight with the same ve- 
 locity when applied to a bone ; because the levers 
 they act with must be as their lengths, and there- 
 fore the penniform and short thick muscles are 
 never applied to a bone for the sake of strength, nor 
 long fibred muscles for quickness ; for whatever is 
 gained by the form of the muscle, whether strength 
 or quickness, must be lost by their insertions into 
 
TO TH£ MUSCLES. 
 
 65 
 
 the bone, or else the muscles must not act all they 
 can, or the bones have less motion than they are 
 made for. 
 
 In the limbs several muscles pass over two 
 joints, both of which are liable to move at once, 
 with force proportionable to the levers they act 
 with upon each joint ; but either joint being fixed 
 by an antagonist muscle, the whole force of such 
 muscles will be exerted upon the other joint ; 
 which in that case may be moved with a velocity 
 equal to what is in both joints, when these muscles 
 act upon both at once. This mechanism is of 
 great use in the limbs, as I shall shew in the prop- 
 er places. 
 
 That only we call the proper use and action 
 of any muscle which it has without the necessary 
 assistance of any other muscle, and what that is 
 in a muscle moving a joint we may always know 
 in any situation, and with what force it acts, cae- 
 teris paribus, by dropping a line, from the centre 
 of motion of the joint it moves, perpendicular into 
 the axis of the muscle ; but in a joint which ad- 
 mits only of flection and extension, this line must 
 also be perpendicular to the axis of motion in that 
 joint, and the action of the muscles will be in the 
 direction of that perpendicular line, and the force 
 with which it acts in any situation will be, caeteris 
 paribus, as the length of that perpendicular line. 
 
 Each muscle, so far as it is distinct, and is moved 
 against any part, is covered with a smooth mem- 
 
66 
 
 INTRODUCTION, &C. 
 
 brane to make the friction easy ; but where they 
 are externally tendinous, those tendons are often 
 smooth enough to make such a covering needless. 
 Besides this membrane there is another, known by 
 the name of fascia tendinosa, which deserves to be 
 particularly considered. The strong one on the 
 outside of the thigh, which belongs to the fascialis 
 and gluteus muscles, is of great use in raising the 
 gluteous farther from the centre of motion of the 
 joint it moves, to increase its force : in like manner 
 the fascia detached from the tendon of the biceps 
 cubiti alters its directions for the same purpose, but 
 those on the outside of the tibia and cubit, &c. are 
 only flat tendons from which the fibres of the 
 muscles arise as from the bones. There are also 
 in many places such tendons between the muscles, 
 from which each muscle arises in like manner ; for 
 the bones themselves are not sufficient to give 
 origin to half the fibres of the muscles that belong 
 to them ; besides, if all the fibres had rise from 
 the bones, they must have been liable to compress 
 one another very inconveniently. 
 
OF THE MUSCLES. 
 
 67 
 
 CHAPTER II. 
 
 OF THE MUSCLES. 
 
 OBLIQUUS descendens arises fleshly from near 
 the extremities of the eight inferior ribs, the 
 upper part of its origin being indented with 
 the seratus major anticus, and the lower lying 
 under a small portion of the latissimus dorsi. 
 It is inserted fleshly into the upper part of the spine 
 of the ilium, and by a broad flat tendon, (which 
 firmly adheres to a like tendon of the following 
 muscle as they pass over the rectus) into the os 
 pubis, and linea alba, which is a strong tendinous 
 line extended from the os pubis to the sternum, 
 between the musculi recti. 
 
 Obliquus ascendens arises fleshly under the 
 former muscle from the spine of the ilium, and is 
 inserted fleshly in the cartilages of the three lowest 
 ribs, and by a flat tendon into the sternum, and 
 linea alba, together with the tendon of the forego- 
 ing muscle. The line in which these two tendons 
 join on the outside of the rectus muscle, is called 
 semilunaris : and though so much of this muscle 
 as is inserted fleshly runs obliquely upward, yet the 
 middle and lower part is directed transverse and 
 downward ; and beside the tendon, which it unites 
 with the obliquus descendens, it often detaches 
 another near the sternum to be inserted with the 
 transversalis under the rectus. 
 
68 
 
 OF THE MUSCLES, 
 
 Pyramidalis arises from the os pubis, and is 
 inserted into the linea alba, about three or four 
 inches below the navel : this and its fellow are 
 often wanting. 
 
 Rectus arises tendinous from the os pubis, but 
 fleshy when the pyramidales are wanting, and is 
 inserted into the lower part of the sternum, near 
 the cartilago ensiformis. This muscle is divided 
 into four or five portions by transverse tendinous 
 intersections, that it might conveniently' bend when 
 the body is bowed forwards, though this muscle 
 should be then in action ; and these intersections 
 are chiefly above the navel, where it is most liable 
 to be bent : besides, being thus divided, its chief 
 pressure will not be in its middle, but under the 
 several bellies of the muscle, and the greatest below 
 the navel, where is the longest fleshy belly of this 
 muscle, and where the parts in the abdomen seem 
 to want most to be supported. 
 
 Transversalis arises by a flat tendon from the 
 transverse processes of the lumbal vertebrae, and 
 fleshy from the inside of the ribs below the diar 
 phragm, and from the spine of the ilium ; then, 
 becoming a flat tendon, it passes under the rectus 
 to its insertion into the linea alba. Between this 
 tendon and the peritoneum sometimes water is 
 found in great quantities, which distemper is 
 called the dropsy in the duplicature of the peri- 
 toneum ; which shews this membrane has been 
 mistaken for part of the peritoneum. 
 
OF THE MUSCLES. 
 
 69 
 
 These five pair of muscles all conspire to 
 compress the parts contained in the abdomen. 
 The obliquus descendens on the right side, and 
 ascendens on the left acting together, turn the 
 upper part of the trunk of the body towards the 
 left, and vice versa ; but the trunk is chiefly 
 turned upon the thighs ; the recti bend the body 
 forward, and pull the sternum downward in ex- 
 piration ; the two oblique muscles and the trans- 
 verse on each side near the groin, are perforated 
 to let through the processus vaginalis with the 
 spermatic vessels. These perforations are distant 
 from each other, so as to suffer the vessels to 
 descend conveniently into the scrotum : this way 
 the intestines or the omentum descend in rup- 
 tures. 
 
 Cremaster testis is a small portion of fibres 
 which arises from the ilium, and appears to 
 be part of the obliquus ascendens muscle, till it 
 meets with the spermatic vessels at their coming 
 out of the abdomen, where it begins to descend 
 with them by the side of the processus vaginalis, 
 to the testicle, over which it is loosely expanded. 
 This muscle is too small to be plainly discovered 
 in emaciated bodies. 
 
 Erector penis arises from the os ischium, and 
 is inserted into the crus penis near the os pubis. 
 It is said, by pressing the penis against the os pubis 
 to compress the vena ipsius penis, and hinder the 
 reflux of blood, whereby the penis becomes ex- 
 
70 
 
 OF THE MUSCLES. 
 
 tended and erect : but it does not appear to me to 
 be well contrived for that use. 
 
 Accelerator urinas. This, with its fellow, 
 are but one muscle. It arises tendinous from the 
 ossa ischia, and fleshy from the sphincter ani j or, 
 according to Mr. Cowper, from the superior part 
 of the urethra as it passes under 'the os pubis : and 
 thence being expanded over the bulb of the 
 urethra, it afterwards divides, and is inserted into 
 the penis. The use of this muscle is not to acceL 
 erate the urine, for that is propelled by the detrusor 
 urinas, or muscular coat of the bladder, but to pro- 
 trude the semen, which is done only by this : and 
 it being seated opposite to the os pubis, it seems to 
 be much better fitted to be a relaxer of the penis, 
 by pulling it from the os pubis, than the erector is 
 for the office assigned it. 
 
 Transversalis penis is that part of the former 
 muscle which arises from the ossa ischia. 
 
 Sphincter vesicas urinariae is a small portion of 
 muscular fibres, not easily to be distinguished, run- 
 ning round the neck of the bladder to prevent the 
 involuntary effusion of urine. 
 
 Detrusor urinae is the muscular coat of the blad- 
 der ; its fibres are differently disposed ; but chiefly 
 terminating in the sphincter vesica, whereby it not 
 only presses the urine forward, but, when the blad- 
 der is full, becomes an antagonist to the sphincter, 
 acting almost at right angles. 
 
OF THE MUSCLES. 
 
 71 
 
 Erector clitoridis arises from the ischium, and 
 is inserted into the crus clitoridis, like the erector 
 penis in men, and is said to cause erection in the 
 same manner. 
 
 Sphincter vaginas is an order of muscular fi- 
 bres, intermixed with membranous fibres, surround- 
 ing the vagina uteri near its orifice ; it is connect- 
 ed to the ossa pubis and sphincter ani ; its use is 
 to constringe the orifice of the vagina, to press out 
 a liquor from the glands of the vagina, and em- 
 brace the penis in coition. 
 
 Dr. Douglas mentions two pair of muscles of 
 the vagina, of his own discovering, which I have 
 never dissected, and will therefore give them in his 
 own words ; “ The first arises from the inner edge 
 of the os pubis midway between the ischion and 
 the beginning of the crus clitoridis, is inserted in- 
 to the vagina ; the second arises tendinous and 
 fleshy from the os pubis internally in common 
 with the levator ani, is inserted into the upper 
 part of the vagina at the side of the meatus urina- 
 rius or collum vesica.” 
 
 “ Sphincter ani is a muscle near two inches in 
 breadth, surrounding the anus to close it, and to 
 prevent involuntary falling out of the feces. 
 
 Levator ani, by Dr. Douglas called two 
 pair of muscles, but Mr. Cowper describes the 
 whole as one muscle only, which arises from the 
 ossa ischii, pubis, and sacrum within the pelvis, and 
 is inserted round the lower end of the rectum in- 
 testinum. 
 
OF THE MUSCLES. 
 
 72 
 
 Fistulee in ano, that arc within this muscle* 
 generally run in the direction of the gut, and may 
 be laid open into the gut with great safety ; but 
 those fistula;, or rather abscesses, that are frequently 
 formed on the outside of the sphincter, and usually 
 surround it, all but where this muscle is connected 
 to the penis, cannot be opened far into the gut, 
 without totally dividing the sphincter, which, au- 
 thors say, renders the sphincter ever after incapable 
 of retaining the excrement. One instance of this 
 kind I have known ; but Mr. Berbeck of York, an 
 excellent surgeon, and particularly famous for this 
 operation, has assured me, that he has often been 
 forced to divide the sphincter, which has made the 
 patients unable to hold their excrements during 
 their cure, but the wounds being healed, they have 
 retained them as well as ever. 
 
 Coccygei arise from the acute processes of the 
 ossa ischii, and are inserted into the os coccygis, 
 which they pull forward. 
 
 Occipito-frontalis, is a muscle with four fleshy 
 bellies, commonly named frontales and occipi- 
 tales. It arises behind each ear from the os oc- 
 cipitis, and soon becoming tendinous, passes un- 
 der the hairy scalp to the forehead, where it be- 
 comes broad and fleshy, adhering to the skin, and is 
 inserted into the upper part of the orbicular muscles 
 of the eyelids, into the os frontis near the nose, and 
 by two processes into the bones of the nose. When 
 this muscle acts from the back part it pulls the 
 
OF THE MUSCLES. 
 
 skin of the forehead up\tafd, and wrinkles it trans- 1 
 verse, and in some persons the hairy scalp back-* 
 wards ; but when the fore part of it acts, it draws 
 the skin with the eyebrows downward, and towards 
 the nose when we frown. The tendon of this mas* 
 cle has been mistaken for a membrane, and been 
 called pericranium, and the true pericranium, pe- 
 riosteum. 
 
 Elevator auricula; arises from the tendon of 
 the occipito-frontalis, and is inserted into the 
 upper part of the ear that is connected to the 
 head. 
 
 Retractor auricula; arises by one, two, or 
 three small portions from the temporal bone above 
 the mammillary process, and is inserted into the ear 
 to pull it backward. 
 
 Orbicularis palpebrarum surrounds the eye- 
 lids on the edge of the orbit, and is fixed to the 
 sutura transversalis at the great corner of the eye ; 
 it fliuts the eyelids, especially in winking. That 
 part of this muscle that lies under the eyebrow is 
 very much intermixed with the occipito-frontalis ; 
 and under it, from the os frontis near the nose-, 
 arises a small portion of distinct fibres which end in 
 this muscle, and, I think, are a part of it ; neverthe- 
 less, from the effect of their action, are not improp- 
 erly called musculus corrugator. 
 
 Ciliaris is a very small portion of this muscle, 
 next the ciliary cartilages of the eyelids. 
 
 L 
 
74 
 
 OF THE MUSCLES. 
 
 Elevator palpebrse superioris rectus rises above 
 the optic nerve, from the periosteum at the bot- 
 tom of the orbit, as do also the five following 
 muscles, and is inserted into the whole ciliary- 
 cartilage of the upper eyelid by a very thin flat 
 tendon. 
 
 Elevator oculi arises from the bottom of the 
 orbit, between the optic nerve and the foregoing 
 muscle, and is inserted in the upper part of the tu- 
 nica sclerotis of the eye, near the cornea. 
 
 Depressor oculi arises, and is inserted directly 
 opposite the last described muscle. 
 
 Adductor oculi arises from the bottom of the 
 orbit, near the optic nerve internally, and is in- 
 serted into the tunica sclerotis on the side next 
 the nose. 
 
 Abductor oculi has both its origin and inser- 
 tion directly opposite to the adductor. 
 
 Obliquus superior seu trochlearis arises between 
 the elevator and adductor oculi at the bottom 
 of the orbit, thence ascending by the sutura trans- 
 versalis, becomes a round tendon, which palling 
 through a pulley at the upper and inner part of the 
 orbit near its edge, is inserted near the bottom of 
 the globe of the eye, which it pulls upward and 
 inward, and thereby directs the pupil outward and 
 downward. 
 
 Obliquus inferior arises from the os maxil- 
 lae superioris, at the edge of the orbit ; thence 
 passing over the depressor is inserted near the ab- 
 
OF THE MUSCLES. 
 
 75 
 
 ductor at the bottom of the eye ; but not so low 
 as the insertion of the obliquus superior : it turns 
 the pupil upward and outward. 
 
 These muscles are inserted with great advan- 
 tage to move a small weight, and are very long, 
 that the eye may be moved with sufficient quick- 
 ness. The two oblique muscles are an axis to the 
 motions of the other four, and acting strongly 
 against them, which action I take to be what is 
 vulgarly called straining the eye, may, I think, 
 bring the crystalline humour nearer to the retina, 
 and possibly may make the crystalline humour 
 more flat to fit the eye for objects at a great dis- 
 tance. For this end it seems to me that there are 
 six muscles thus disposed, when three might be 
 sufficient to turn the eye every way, if it was in a 
 proper fixed socket : and it seems also, that while 
 the muscles are all thus in action, the superior ob- 
 lique in each eye sets the pupil farther from the 
 nose, while the inferior oblique directs it upward ; 
 the first of which actions is always necessary, and 
 the latter often so, when we look with both eyes 
 at very distant objects ; and when the two oblique 
 muscles grow weak by age or disease, or cease to 
 act at all, as in paralytic cases, and death, then the 
 eye sinks in the orbit. 
 
 Sphincter, or constrictor oris, surrounds the 
 mouth about three fourths of an inch broad. This 
 muscle is very much intermixed with all the mus- 
 cles that are inserted into it. 
 
76 
 
 OF THE MUSCLES. 
 
 Elevator labii superioris proprius arises from 
 the bone of the upper jaw under the anterior and 
 inferior part of the orbicularis palpebrarum, and 
 usually takes another small beginning from the os 
 malae, which seems as if it was sent off from the 
 orbicularis palpebrarum ; and passing down by the 
 side of the nose, into which it sends some fibres, is 
 inserted into the upper part of the sphincter oris. 
 This raises the upper lip, and helps to dilate the 
 nostrils, 
 
 Depressor labii superioris proprius is a small 
 muscle arising from the upper jaw, near the dentes 
 incisorii, and is inserted into the upper part of the 
 lip and root of the cartilages of the nose ; hence it 
 is also a depressor of the nose, which action con- 
 stricts the nostrils. 
 
 Depressor labii inferioris proprius arises broad 
 from the lower jaw at the chin, and is soon insert- 
 ed into the sphincter oris ; the order of fibres in 
 this seems not so conspicuous as in the other mus- 
 cles of the face. 
 
 Elevator labii inferioris proprius arises from the 
 lower jaw, near the dentes incisorii, and is insert- 
 ed into the lower part of the lip. 
 
 Elevator labiorum communis arises from a de- 
 pressed part of the superior maxilla under the mid- 
 dle of the orbit, and is inserted into the sphincter 
 muscle near the corner of the mouth. 
 
 Depressor communis labiorum arises later- 
 ally from the lower jaw near the chin, and Is 
 
or THE MUSCLES. 77 
 
 inserted into the sphincter opposite to the for- 
 mer. 
 
 Zygomaticus arises from the anterior part of 
 the os zygoma or malae, and frequently derives a 
 portion of fibres from the orbicularis palpebrarum., 
 thence running obliquely downwards. It is inserted 
 into the sphincter at the corner of the mouth, be- 
 twixt the elevator communis and buccinator ; It 
 draws the corner of the mouth outward and upward. 
 When this muscle grows weak, the corner of the 
 mouth sinks, as may be observed in old persons. 
 
 Buccinator arises from the processus coronas 
 of the lower jaw, and passing contiguous to both 
 jaws, is inserted into the sphincter muscle at the 
 corner of the mouth. It serves either to force 
 breath out of the mouth, or thrust the aliment 
 between the teeth in mastication, or to pull the 
 corner of the mouth outward. 
 
 Platysma myoides arises loosely from over the 
 pectoral and part of the deltoid muscle, and run- 
 ning obliquely forward, is inserted into the chin, 
 and depressor muscles of the lips. This muscle 
 being exceeding thin, a mere membrana carno- 
 sa, serves to cover the unequal surface of the 
 subjacent muscles, and render the neck even ; it 
 also pulls down the corner of the mouth, and, from 
 its insertion at the chin, may contribute to the pull- 
 ing down of the lower jaw. 
 
 Retractor alas nasi is a very small muscle aris- 
 ing from the bone of the nose, and is inserted 
 
78 or THE MUSCLES. 
 
 into the skin and cartilage at the side of the 
 nose. 
 
 Mylohyoideus with its fellow may be esteem- 
 ed one penniform or else a digastric muscle. It 
 arises from the linea aspera on the inside of the 
 lower jaw and processus innominatus, both sides 
 meeting at about right angles in a middle line upon 
 the following muscles. It is inserted by a small 
 portion of fibres into the basis of the os hyoides ; 
 it moves the tongue upward and forward, and also 
 compresses the following muscles, whereby they 
 raise the tongue more commodiously, and also hin- 
 ders them from drawing the basis of the os hyoi- 
 des into a right line betwixt the chin and sternum 
 at such times as the stylohyoidei cannot act. 
 
 Geniohyoideus arises from the processus in- 
 nominatus of the lower jaw, under the foregoing 
 muscle, and is inserted into the basis of the os hy- 
 oides which it pulls upward and forward. This, 
 with its fellow, are for the most part but one 
 muscle. 
 
 Stylohyoideus arises from the processus styli- 
 formis, near its root, and passing contiguous to the 
 horn of the os hyoides becomes inserted laterally 
 into its basis. This muscle is sometimes perforated 
 about the middle, by the tendon of the digastric 
 muscle of the lower jaw. Its use is to pull the os 
 hyoides up and backward. 
 
 Coracohyoideus arises from the upper costa 
 of the scapula, near the processus coracoides, and 
 
OF THE MUSCLES. 79 
 
 passing under the mastoideus muscle becomes in 
 that place a round tendon ; thence passing almost 
 parallel to the following muscle, is inserted togeth- 
 er with it into the basis of the os hyoides ; this 
 draws the os hyoides downward, and a little back- 
 ward. I have once seen one of these muscles want- 
 ing, and the sternohyoideus arising from the mid- 
 dle of the clavicle on that side. 
 
 Sternohyoideus arises from a roughness at the 
 under part of the clavicula near the sternum, 
 and the cartilaginous part of the first rib ; and is 
 inserted into the basis of the os hyoides, to pull it 
 downward. 
 
 Genioglossus arises from the processus innom- 
 inatus of the lower jaw, and is inserted broad 
 into the under part of the tongue, to pull it up and 
 forward, and sometimes has a small insertion into 
 the os hyoides. 
 
 Basioglossus seems a portion of the former mus- 
 cle ; it arises from the basis of the os hyoides, and 
 is inserted into the tongue nearer its tip. 
 
 Ceratoglossus arises from the horn of the os hy- 
 oides, and is laterally inserted into the tongue 
 near its root, to pull it downward and forward. 
 
 Styloglossus arises from the extremity of the 
 processus styliformis, and is inserted into the tongue 
 near the former to pull it up and backward. I 
 have very often found another styloid muscle so in- 
 serted, that I cannot tell whether to call it a muscle 
 of the tongue or pharynx. 
 
80 
 
 oe thc jftrsdtrSr 
 
 The tongue is a muscle made of fibres, Ion* 
 gitudinal, circular, and transverse, so intermixed as 
 best to serve its several motions. 
 
 Hypothyroideus or Ceratothyroideus, arises from 
 part of the basis, and the horn of the os hy- 
 oides, and is inserted into the lower part of the 
 cartilago thyroides, to pull it forward. 
 
 Sternothyroideus arises from the inside of the 
 sternum, and is inserted with the former ; it pulls* 
 the thyroid cartilage directly downward. 
 
 Cricothyroideus arises from the anterior part 
 or the cartilago cricoides, and running obliquely up- 
 ward and outward, is soon inserted into the inside 
 of the cartilago thyroides, which it pulls towards 
 the cartilago cricoides. Both this muscle and its 
 fellow for the most part appear double. 
 
 Cricoarytsenoideus posticus arises from the back 
 part of the cartilago cricoides, and is inserted into 
 the arytsenoides to pull it backward. 
 
 Cricoarytsenoideus lateralis arises laterally from 
 the cartilago cricoides, and is inserted laterally into 
 the arytsenoides. This, with its fellow, pull down 
 each cartilage toward their origin, and thereby 
 dilate the rimula. 
 
 Thyroarytsenoideus arises from the superior, 
 middle, and inner part of the cartilago thyroides, 
 and is inserted with the former into the ary- 
 taenoides cartilaere to dilate the rimula. These 
 two last described muscles are not naturally divided, 
 and therefore ought to be accounted but one muscle. 
 
of The muscles. 
 
 §1 
 
 Arytsenoideus is one single muscle, which arises 
 from one arytsenoidal cartilage, and is inserted in- 
 to the other, to draw them together, and close the 
 rimula. These few small muscles of the tongue 
 and larynx, with only one pipe, make a great va- 
 riety of notes and sounds that can be made by ar- 
 tificial instruments, and that in a manner so little 
 understood by us, and by organs so little differing 
 from those in quadrupeds, that, for aught we know 
 of them, brutes might be as capable of all these 
 sounds as men. 
 
 Stylopharyngseus arises from near the bottom 
 of the processus styloides of the os petrosum, 
 and running obliquely downward, is insert- 
 ed into the pharynx. This muscle, with its 
 fellow, pulls up and dilates the pharynx to receive 
 the aliment. 
 
 CEsophageus arises like a wing from several 
 parts of the scull, tongue, os hyoides, the cricoid 
 and thyroid cartilages, and is inserted into the 
 pharynx. This, with its fellow, constringes the 
 pharynx, and presses the aliment down the gullet. 
 
 Musculus vaginalis guise is the muscular coat of 
 the gula. 
 
 Pterygopharyngseus is not a distinct muscle, 
 but the beginning of the pharynx near the pro- 
 cessus pterygoides of the sphenoidal bone. 
 
 Pterygostaphylinus internus arises from the 
 os sphenoides, near the iter ad palatum, or 
 eustachian tube, and is inserted into the uvula. 
 
 M 
 
82 
 
 OF THE MUSCLES. 
 
 which it pulls up while we breathe through the 
 mouth, or swallow. 
 
 Pterygo-staphylinus externus arises by the 
 side of the last described muscle, and is also in- 
 serted near it ; but becomes its antagonist by be- 
 ing reflected on a pulley, over a process at the 
 lower part of the pterygoidal processes of the sphe- 
 noidal bone. 
 
 Glosso-staphylinus is a very small portion of 
 muscular fibres, which pass from the tongue to 
 the palate, which it pulls down when we breathe 
 through the nose. 
 
 The palate itself is a sort of double muscle, 
 whose action seems only to support itself, and assist 
 those muscles which pull it upwards. 
 
 Digastricus arises from sinus of the mammil- 
 lary process of the os temporis, and, from a fleshy 
 belly becoming a round tendon, passes through, 
 and sometimes under, the stylohyoideus muscle ; 
 and then, being tied down by a ligament to the os 
 hyoides, grows fleshy, and is so inserted into the 
 anterior part of the lower jaw internally. This 
 muscle’s direction being altered by its being tied to 
 the os hyoides, where it makes an angle, and not 
 at its passage through the stylohyoideus, pulls the 
 lower jaw downward with much greater force 
 than otherwise it could have done ; and being con- 
 nected to the os hyoides, when it acts, it prevents 
 the action of several muscles which are concerned 
 in swallowing ; whence it is that we cannot swal- 
 
OF THE MUSCLES. 
 
 83 
 
 iow at the same time that we open the jaw, as 
 those brutes can whose digastric muscles are not 
 connected to that bone. 
 
 Temporalis arises from the os frontis, parie- 
 tale, sphenoides, malse, and temporis, and, passing 
 under the two processes named os jugale, is inserted 
 externally into the processus coronalis of the lower 
 jaw, which it pulls upward. This muscle is covered 
 with a strong tendinous fascia. 
 
 Masseter arises from the lower edge of the 
 os malse or zygoma, and the process which joins 
 this from the temporal bone, and is inserted into the 
 outer part of the angle of the lower jaw, which it 
 pulls up and forward. These two last described 
 muscles having different directions, when they act 
 together, make a steady motion in the diagonal of 
 their directions. 
 
 Pterygoideus interims arises from the pro- 
 cessus pterygoideus externus, and from the sinus 
 between the pterygoid processes, and is inserted 
 internally into the angle of the lower jaw, which 
 it pulls upward. 
 
 Pterygoideus externus arises from the os max- 
 illare and os sphenoides, near the root of the exter- 
 nal pterygoid process, and is inserted internally 
 into the processus condyloides of the lower jaw, 
 which it pulls to one side, and forwards, or acting 
 with its fellow pulls the jaw directly forward. 
 
 Subclavius arises from the superior part of the 
 first rib, and is inserted into more than half the 
 
84 
 
 OF THE MUSCLES. 
 
 underside of the clavicula next the scapula. Its use 
 is to draw the clavicula toward the sternum, that 
 they may not be severed in the motions of the 
 scapula. 
 
 Trapezius arises from the os occipitis, and 
 from a linea alba colli, from the spinal process of 
 the last vertebra of the neck, and the ten upper- 
 most of the back, and from a linea alba between 
 all these processes ; and is inserted into one third of 
 the clavicle next the scapula, almost all the back 
 part of the spine of the scapula, and as much of 
 the processus acromion as lies between the spine of 
 the scapula and the clavicle. This muscle draws the 
 scapula directly backward. 
 
 It is generally said by authors, that the several 
 parts of this muscle act at different times, and so 
 pull the scapula different ways, as obliquely up- 
 ward, downward, or backward ; but, I think, if 
 that happened, it must necessarily divide this mus- 
 cle into distinct portions, those that contract always 
 separating from those that do not. 
 
 Rhomboides arises tendinous under the former 
 from the spinal process of the inferior vertebra of 
 the neck, part of the linea alba colli, and from the 
 spinal processes of the four or five uppermost ver- 
 tebrae of the thorax, and is inserted into the basis 
 of the scapula, which it pulls up and backward. 
 The upper part of this muscle arising from the 
 neck, is, in many bodies, by the motions of the 
 neck, separated and made a distinct muscle. 
 
OF THE MUSCLES. 
 
 85 
 
 Elevator scapulae arises from the transverse 
 processes of the four superior vertebrae of the 
 neck, and is inserted into the upper angle of the 
 scapula. 
 
 Serratus minor anticus arises under the pecto- 
 ralis, from the third, fourth, and fifth ribs, and 
 is inserted into the processus coracoides scapu- 
 lae, which it pulls forward and downward. This 
 muscle is always said to be an elevator of the ribs, 
 though it arises from the scapula, which is sup- 
 ported by the ribs. 
 
 Serratus major anticus arises from the anterior 
 part of the eight superior ribs, and is inserted 
 into the basis of the scapula, which is draws for- 
 ward, and by that means moves the socket of the 
 scapula upward. This muscle has been always 
 accounted an elevator costarum, though each por- 
 tion of it is nearly parallel to the rib it rises from. 
 
 All the muscles inserted into the basis of the 
 scapula are also inserted into one another. 
 
 Pectoralis arises from near two thirds of the 
 clavicula, next the sternum, and all the length of 
 the os pectoris, and from the cartilages of the ribs, 
 and is inserted into the os humeri, between the bi- 
 ceps and the insertion of the deltoides. The use of 
 it is to draw the arm forward. A small portion of 
 the lower part of this muscle is often confounded 
 with the obliquus descendens abdominis ; and in 
 some bodies, neither the upper part, nor its tendon, 
 can be easily separated from the deltoides ; and in 
 
86 
 
 OF THE MUSCLES. 
 
 others, even that part of it that arises from the 
 clavicula is a distinct portion. Near the insertion 
 of this muscle the fibres cross those from below, 
 ending above in the arm, and those from above 
 below, that the tendon of this muscle might not 
 lie inconveniently low between the arm and thorax, 
 as it would have done had the fibres which arise 
 lowest from the sternum been inserted lowest in the 
 arm ; but this crossing does not make the tendon 
 at all stronger, as is often said ; nor can I see how 
 it came to be thought that this tendon should want 
 more strength in proportion than other tendons. 
 
 Deltoides arises exactly opposite to the inser- 
 tion of the trapezius, from one third part of the 
 clavicula, from the acromion and spine of the sca- 
 pula, and is inserted tendinous near the middle of 
 the os humeri, which bone it lifts directly upward. 
 The outermost parts of this muscle, when the arm 
 hangs down, lie below the centre of motion of the 
 joint, and therefore can have no share in lifting the 
 humerus up, till it is raised part of the way by the 
 other part of this muscle, and the following muscle ; 
 and as the outer parts of this muscle begin to act, 
 the following muscle acts with less advantage : 
 and it seems to me, that the sole reason why this 
 muscle is made of so many parts, is, that they 
 may act independently ; for it is demonstrable, that 
 this muscle, when the whole of it acts, cannot raise 
 the arm with so great advantage as a right lined 
 muscle of the same magnitude would have done. 
 
OF THE MUSCLES. 
 
 87 
 
 Supraspinatus arises from the dorsum scapulas 
 above the spine, and passing between the two pro- 
 cesses, is inserted into the upper part of the os hu- 
 meri, which it helps to raise until it becomes par- 
 allel with the spina scapulas. 
 
 The supraspinatus, the deltoides, and coracobra- 
 chialis assist in all the motions of the humerus ex- 
 cept depression ; it being necessary that the arm 
 should be raised and sustained, in order to move it 
 to any side. 
 
 Infraspinatus arises from the dorsum scapulas 
 below the spine, and is inserted, wrapping over 
 part of it, at the side of the head of the os humeri ; 
 it turns the arm supine and backward ; for there is 
 a prone and supine rotatory motion of the hume- 
 rus of near ninety degrees. 
 
 Teres minor is a small muscle arising below 
 the former from the inferior costa scapulae, and is 
 inserted together with it. It assists the former in 
 turning the arm supine, but pulls it more down- 
 wards. 
 
 Teres major arises from the lower angle of the 
 scapula, and is inserted at the under part of the os 
 humeri, about three fingers breadth from the head. 
 This draws the os humeri toward the lower angle 
 of the scapula, and turns the arm prone and back- 
 ward. 
 
 Latissimus dorsi arises by a flat tendon from 
 the spinal processes of the seven or eight inferior 
 vertebrae of the back, and those of the loins, sa- 
 
88 
 
 OF THE MUSCLES. 
 
 crum, and ilium : and growing fleshy, after it has 
 passed the extensors of the trunk, receives another 
 small fleshy beginning from the ninth, tenth, and 
 eleventh ribs, and is inserted into the os humeri, 
 with the former. This turns the arm backward, 
 and prone. The tendon of this muscle serves for 
 a membrane to the extensors of the back, and is 
 connected to the transverse processes of the ver- 
 tebrae lumborum. 
 
 Subscapularis arises from the hollow side of 
 the scapula, which it fills up, and is inserted in- 
 to the head of the os humeri, wrapping some- 
 what over it. This pulls the arm to the side and. 
 prone. 
 
 Coracobrachialis arises from the processus cora- 
 coides scapulae, in common with the origin of one 
 head of the biceps, and is inserted into the os hu- 
 meri internally about its middle. This raises the 
 arm, and turns it somewhat outward. 
 
 Biceps cubiti flexor arises with two heads, 
 that the fibres of this muscle might not compress 
 one another, one from the processus coracoides sca- 
 pulae, in common with the coracobrachialis mus- 
 cle, and the other by a round tendon from the edge 
 of the acetabulum scapulae, which passing in a sul- 
 cus of the os humeri, afterward becomes fleshy, 
 and joins the first head to be inserted with it into 
 the tubercle of the radius ; and sometimes this 
 muscle has a third head, which arises from the 
 middle of the os humeri. This muscle lifts up the 
 
OF THE MUSCLfcSo 
 
 89 
 
 humerus, bends the cubit, and has as great a share 
 as any one muscle in turning the cubit supine ; the 
 humerus being fixed by other muscles, the whole 
 force of this muscle will be exerted upon the cu- 
 bit ; or the cubit being fixed by an extensor, the 
 whole force of it will be spent in raising the arm, 
 and therefore ought to be ahvays reckoned among 
 those that raise a weight at arms length. A punc- 
 ture of the tendinous expansion of this muscle is 
 supposed to be always attended with grievous pain 
 and inflammation, and has, if we have not mis- 
 taken the cause, often proved mortal ; yet many 
 eminent surgeons have given instances of larger 
 tendons being cut and stitched, without any bad 
 symptoms ; and we have often seen them cut, 
 torn, ulcerated, and mortified, without any more 
 sign of pain than in other parts. So that I can- 
 not see what the great mischief of pricking this 
 tendinous fascia is owing to, unless its lying so 
 much upon the stretch, which may be wholly 
 avoided by bending the elbow, and turning the 
 cubit prone. Since I have considered this case, 
 
 I have met with one who was thus injured by 
 an injudicious blood-letter, who ordered the pa- 
 tient to keep her arm extended for fear of a con- 
 traction, and she was not without the most violent 
 pain for a wdiole fortnight ; but upon bending the 
 cubit, and turning the arm prone, she grew pres- 
 ently easy, and, in a few days, well. Neverthe- 
 less, I am persuaded, that most of the accidents 
 
 N 
 
90 
 
 ®F Tf H£ MUSCLES. 
 
 which are thought to be merely from blood-let- 
 ting, are critical discharges of some disease, and 
 from the puncture a small inflammation begin* 
 ning, increases and suppurates. But however sin- 
 gular I may be thought in this opinion, I can be 
 sure I am disinterested in it, having never had any 
 ill accident follow blood-letting in my life. 
 
 Brachiaeus inter nus arises from below the mid- 
 dle of the os humeri, and is inserted into a rough 
 place of the ulna, immediately below the the junc- 
 ture. This also bends the cubit. 
 
 Supinator radii longus arises from the t lower 
 and outer part of the os humeri, and is insert- 
 ed into the upper side of the radius, near- the 
 carpus. This muscle is not a supinator but a 
 bender of the cubit, and that with a longer lev- 
 er than either of the two former muscles, and 
 is less concerned in turning the cubit supine, 
 than either the extensors of the carpus, fingers, or 
 thumb. 
 
 Triceps extensor cubiti, commonly distinguish- 
 ed into biceps and brachiseus externus. The first 
 of these heads arises from the lower costa of the 
 scapula near the acetabulum ; the second from the 
 outer and back part of the os humeri ; the third, 
 lower and more internal ; and are inserted into 
 the processus olecranon of the ulna. The first of 
 these heads draws the arm backward, with as long a 
 lever as it extends the cubit. 
 
eF THE MUSCLES. 91 
 
 Anconseus arises from the outward extuberance 
 of the os humeri, and is inserted into the upper 
 part of the ulna : this is also an extensor. 
 
 Palmaris longus arises small from the inner extu- 
 berance of the os humeri, and from a short belly- 
 soon becomes a tendon, which is connected to the 
 ligamentum transversale carpi, and expanded in the 
 palm of the hand. This muscle is often wanting, 
 but the expansion in the hand never ; yet it being 
 connected to the ligament of the carpus, it must 
 bend the carpus, and cannot constrict the palm of 
 the hand ; and when it is wanting, the flexor car- 
 pi radialis is larger. 
 
 Palmaris breyis, or caro quadrata, arises obscure- 
 ly from the ligamentum transversale carpi, and 
 seems to be inserted into the eighth bone of the car- 
 pus, and the metacarpal bone of the little finger. 
 This helps to constrict the palm of the hand, and is 
 very different in size in different bodies. 
 
 Flexor carpi radialis arises from the inner extube- 
 rance of the os humeri, and soon becoming a strong 
 tendon, passes through a channel of the fifth bone 
 of the carpus, and is inserted into the metacarpal 
 bone of the fore-finger. This not only bends the 
 carpus upon the radius, but also the bones of the 
 second order upon those of the first ; which mo- 
 tion is nearly as much as that upon the radius. 
 
 Flexor carpi ulnaris arises from the same extu- 
 berance with the former, and a fascia betwixt this 
 muscle and the tensor ulnaris contiguous to the 
 
92 
 
 07 THE MUSCLES. 
 
 ulna, and is inserted by a short tendon into the 
 fourth bone of the carpus. 
 
 Extensores carpi radiales ; the first arises from 
 the os humeri, immediately below the supinator 
 radii longus, and is inserted into the metacarpal 
 bone of the first finger ; the second arises immedi- 
 ately below this, from the outer extuberance of the 
 os humeri, and is inserted into the metacarpal bone 
 of the second finger. The first of these muscles is 
 a bender of the cubit, as well as an extensor of the 
 carpus, and its often acting with the benders of the 
 cubit while the other is not in action, is the reason 
 why it is so distinct from it. 
 
 Extensor ulnaris arises from the same extube- 
 rance with the former, and half the ulna below the 
 anconeus muscle ; then becoming a tendon, runs 
 in a small sinus at the bottom of the ulna, and is 
 inserted into the metacarpal bone of the little fin- 
 ger. See Ulna, p. 31, 32. The extensors of the 
 carpus being inserted into the metacarpus, at once 
 perform the motion between the bones of the car- 
 pus, and that between the carpus and radius. The 
 flexor and tensor ulnaris acting together turn the 
 hand downward, the tensor and flexor radialis up- 
 ward. 
 
 Perforatus, or flexor secundi internodii dig- 
 itorum, arises from the inner tubercle of the 
 os humeri, and from the upper part of the 
 ulna, and the middle of the radius ; then becom- 
 ing four strong tendons, passes under the ligamen- 
 
OF THE MUSCLES. 
 
 93 
 
 turn transversale carpi, and is inserted into the be- 
 ginning of the second bone of each finger. 
 
 Perforans, or flexor tertii internodii digitorum, 
 arises from half the ulna, and a great part of the 
 ligament between the ulna and radius, then be- 
 coming four tendons, passes under the ligamen- 
 tum transversale carpi, and through tendons of the 
 former muscle to their insertion into the third 
 bone of each finger. The tendons of both these 
 muscles are tied down to the fingers by a strong 
 ligament. If these muscles had not passed one 
 through the other, the perforatus, which is the 
 lesser muscle, must have gone to the last joint 
 where the stronger muscle is wanted ; and, besides, 
 the tendons of the second joints would have pressed 
 those that bend the last, and not lain firmly upon 
 them neither. 
 
 Lumbricales, or flexores primi internodii digit- 
 orum, arise from the tendons of the last mention- 
 ed muscle, and are inserted laterally toward the 
 thumb into the beginning of the first bone of each 
 finger. 
 
 Extensor digitorum communis arises from the 
 outer extuberance of the os humeri, and passing 
 under a ligament at the wrist, is divided into four 
 tendons, which communicate upon the first joint, 
 which keeps them from sliding off the joints of 
 the fingers, where they are a little connected to the 
 first bones, and afterward are inserted into the be- 
 ginning of the second bone of each finger. 
 
94 
 
 OF TH£ MUSCLES. 
 
 Extensor auricularis, or minimi digiti is a por- 
 tion of the last muscle passing under the ligament in 
 a distinct channel. 
 
 Extensor indicis arises from the middle of the 
 ulna, and passing under the ligament of the car- 
 pus, is inserted with the extensor communis into 
 the fore-finger. This muscle extends the fore-fin- 
 ger singly. I have twice seen it wanting. 
 
 Abductor primi digiti, interossei, and abductor 
 minimi digiti, are eight muscles, one for each 
 side of each finger. Abductor primi digiti 
 arises from the first bone of the thumb, and the 
 side of the metacarpal bone of the first finger. 
 The interossei are three pair, fitly divided into 
 external and internal ; the external arise from 
 the metacarpal bones, whose spaces they fill up 
 next the back of the hand ; the internal arise 
 from the same bones, in the inside of the hand. 
 Abductor minimi digiti arises from the trans- 
 verse ligament, and fourth bone of the carpus ; 
 these muscles are inserted, two into the first joint 
 of each finger, and then passing obliquely over 
 the tops of the fingers, are inserted into their last 
 bones *, they bend the first joints, and extend the 
 two last, as in holding a pen, and in playing upon 
 some musical instruments. The abductors of the 
 fore and little fingers, with the second and fifth 
 interossei muscles acting, the fingers are divari- 
 cated, and the other four acting bring them to- 
 gether, and these muscles which divaricate the 
 
OF THE MUSCLES. 
 
 95 
 
 fingers, being extenders of the second and third 
 joints, we never can divaricate them without ex- 
 tending them a little. 
 
 Adductorossis metacarpiminimi digiti arises from 
 the eighth bone and transverse ligament of the car- 
 pus, and is inserted into the metacarpal bone of the 
 little finger, which it pulls toward the thumb to 
 constrict the palm of the hand. 
 
 Extensor primi internodii pollicis arises from 
 the ulna below the anconeus muscle, and the lig- 
 ament between the ulna and radius ; then becom- 
 ing two, three, or four tendons, is inserted into 
 the fifth bone of the carpus, and first of the 
 thumb. The first of these insertions can only as- 
 sist the bending of the wrist upward, and in turn- 
 ing the arm supine. 
 
 Extensor secundi internodii pollicis arises im- 
 mediately below the former from the radius and 
 transverse ligament, and is inserted by a few fi- 
 bres into the second bone of the thumb, but chief- 
 ly into the third. 
 
 Extensor tertii internodii pollicis arises imme- 
 diately below the last described, from the ulna 
 and ligament, and passes over the radius near- 
 er the ulna, to be inserted at the third bone of the 
 thumb. This extends the thumb more toward 
 the ulna than the former muscle, and is very much 
 a supinator. 
 
 Flexor primi et secundi ossis pollicis arises 
 from the fifth bone and transverse ligament 
 
96 
 
 OF THE MUSCLES. 
 
 of the carpus, and from the beginnings of the two 
 first metacarpal bones, and is inserted into the 
 whole length of the first bone of the thumb, and 
 tendinous into the beginning of the second ; the 
 sesamoid bones of the thumb in such bodies as 
 have them, he in this tendon, where it passes over 
 the joint. 
 
 Flexor tertii internodii pollicis arises large 
 from almost all the * upper part of the radius, 
 and becoming a round tendon, passes under the 
 ligamcntum transversale carpi, to be inserted into 
 the third bone of the thumb. This muscle singly 
 acting, draws the thumb towards the metacarpal 
 bone of the little finger ; but the last mentioned 
 muscle acting with it, turns it toward the fore- 
 finger. 
 
 Adductor pollicis arises from the carpus, and 
 almost the whole length of the metacarpal bone 
 of the long finger, and is inserted into the begin- 
 ning of the second bone of the thumb. This mus-i 
 cle naturally enough divides into two, and might 
 better be called a flexor than adductor. 
 
 Abductor pollicis arises from the fifth bone 
 and ligamentum transversale of the carpus, and 
 is inserted laterally into the beginning of the 
 second bone of the thumb, to draw it toward the 
 radius. 
 
 The muscles which bend the thumb are much, 
 less than those which bend the fingers ; neverthe- 
 less, the thumb is able to resist all the fingers. 
 
OF THE MUSCLES. 
 
 57 
 
 merely from the advantages that arise from the 
 thickness and shortness of the bones of the thumb, 
 compared with those of the fingers ; but then the 
 quickness of motion in the fingers will exceed that 
 of the thumb, as much as the fingers exceed the 
 thumb in length, and their muscles those of the 
 thumb in largeness. 
 
 Supinator radii brevis arises from the outer 
 extuberance of the os humeri, and upper part of 
 the ulna, and running half round the radius, is in- 
 serted near its turbercle. 
 
 Pronator teres arises from the inner apo- 
 physis of the os humeri, and upper and fore part of 
 the ulna, and is inserted tendinous into the radius 
 below the former. t * 
 
 Pronator quadratus arises from the lower edge 
 of the ulna, near the carpus, and passing under the 
 flexors of the fingers is inserted into the radius. 
 
 These muscles are occasionally assisted in their 
 actions by the muscles of the hands, the extensors 
 assisting the supinators, and the flexors the prona- 
 tors, and most of the extensors of the hand take a 
 great part of their origin from the tendinous fascia 
 that covers them. 
 
 Mastoideus arises tendinous from the sternum 
 near the clavicula, and by a separate fleshy por- 
 tion from the clavicula, which soon unites with 
 the other beginning, and is inserted into the outer 
 part of the mammillary process of the temporal 
 bone. It pulls that side of the head it is inserted 
 
 o 
 
98 
 
 OF THE MUSCLES. 
 
 into towards the sternum, and turns the face to- 
 ward the contrary shoulder. This, and its fellow, 
 pull the head and neck toward the breast, and act 
 with a much longer lever upon each lower verte- 
 bra, than they do upon the next above, and with 
 more power upon any of those joints than upon 
 the head. This muscle being inserted into the 
 head, beyond the centre of motion of the head 
 with the first vertebra, has been supposed, by sever- 
 al anatomists, to pull the head backward ; but the 
 passing beyond signifies nothing to that purpose, 
 unless a line going through its axis would pass be- 
 low the centre of motion : and it is the more to be 
 wondered how this mistake prevailed, if we consider 
 that this muscle’s being added to the extensors of 
 the head and neck, would make the force of that 
 action a hundred times greater than that of the 
 benders. And if this is not enough to convince, 
 let any one lying on his back raise his head, and 
 he will soon feel this muscle in action ; but bow- 
 ing the head forward in an erect posture will not 
 shew this unless some resistance is made to the 
 head, because the centre of gravity of the head ly- 
 ing before the centre of motion, there needs no 
 more than a relaxation of the extensors, to bring 
 the head forward in that posture. 
 
 Rectus internus major arises from the anterior 
 part of the transverse processes of the third, fourth, 
 fifth, and sixth cervical vertebrae ; and passing 
 over the two superior, is inserted into a rough- 
 
OF THE MUSCLES. 
 
 99 
 
 ness of the occipital bone near the fore-part of the 
 great foramen. This bends the head on the two 
 first vertebrae of the neck. 
 
 Rectus minor internus arises under the last 
 muscle, from the first vertebra, and is inserted 
 under it into the os occipitis. This bends the head 
 on the first vertebra. 
 
 Rectus lateralis arises from the anterior part of 
 the transverse process of the first vertebra of the 
 neck, and is inserted into the os temporis and 
 occipitis between the mammillary and styloid pro- 
 cesses. This turns the head on one side. 
 
 Splenius arises by a thin tendon from the spi- 
 nal processes of the five superior vertebrae of the 
 thorax, and the lowest of the neck, and linea alba 
 colli, and is inserted into the os occipitis, the up- 
 per part of the mammillary process of the temporal 
 bone, and the transverse processes of the three 
 superior cervical vertebrae. This pulls the head 
 and neck backward, and to the contrary side ; but 
 both of these acting together pull them directly 
 backward. 
 
 Complexus arises from the transverse processes 
 of the six or seven superior vertebrae of the thorax ; 
 and six inferior of the neck, and is inserted into 
 the os occipitis, and back part of the os temporis ; 
 this last part is sometimes distinct enough to be 
 accounted another muscle. It pulls the head and 
 neck back. 
 
100 
 
 or THE MUSCLES. 
 
 Rectus major posticus arises from the spinal 
 processes of the second vertebra of the neck, and 
 is inserted broader into the os occipitis. It pulls 
 the head back on the two first vertebne. 
 
 Rectus minor posticus arises from the back 
 part of the first vertebra of the neck, it having no 
 spinal process, and is inserted below the former into 
 the same bone, to pull the head back on the first 
 vertebra. 
 
 Obliquus superior arises from the transverse pro- 
 cess of the first vertebra, and is inserted into the os 
 occipitis and back part of the os temporis, near 
 the rectus major ; either of these acting, assist the 
 rectus lateralis on the same side ; but both together 
 pull the head back. 
 
 Obliquus inferior arises from the spinal process 
 of the second vertebra of the neck, and is inserted 
 into the transverse process of the first. This, with 
 its fellow, alternately acting, turns the head with 
 the first vertebra in a rotatory manner on the 
 second, whose processus dentatus is the axis of this 
 motion. 
 
 Interspinales colli are three or four pair of mus- 
 cles between the bifid processes of the cervical ver- 
 tebrae, which they draw nearer each other when the 
 neck is bent backward. 
 
 Longus colli arises laterally from the bodies 
 of the four superior vertebrae of the thorax, and 
 from the anterior part of the transverse processes of 
 the five inferior vertebrae of the neck, and is in- 
 
OF THE MUSCLES. 101 
 
 serted into the fore part of the first and second ver- 
 tebrae of the neck, which it bends forward. 
 
 Intertransversales colli are portions of flesh be- 
 tween the transverse processes of the vertebrae 
 of the neck, like the interspinales, but not so dis- 
 tinct ; they draw these processes together. 
 
 Spinalis colli arises from the transverse proces- 
 ses of the five superior vertebrae of the back, and 
 is inserted into the spinal processes of the second, 
 third, fourth, and fifth vertebrae of the neck. This 
 pulls the neck backward. 
 
 Transversalis colli arises from the oblique 
 processes of the four inferior vertebrae of the 
 neck, and is inserted into the spinal process of the 
 second vertebra of the neck. This muscle is but 
 a continuation of the transversalis or semispinalis 
 dorsi. 
 
 The muscles of the head and neck are most of 
 them obliquely directed, which makes them per- 
 form the oblique motions, as well as extension and 
 flexion ; which is highly convenient in this case, 
 because the joints moved by these muscles, being 
 under the weight moved, it is necessary that the 
 head should be kept steady by the extensors, and 
 flexors too, when any great weight is upon the 
 head ; and these muscles, from the obliquity of 
 their directions, not only perform these two actions 
 at once, but acting by pairs they move the head 
 and neck steadily, in a diagonal direction, which 
 ■straight muscles could not have done so well. 
 
102 
 
 OF THE MUSCLES. 
 
 Scalenus arises from the transverse processes 
 of the second, third, fourth, fifth and sixth cervi- 
 cal vertebrae. It is inserted, in three parts, into 
 the two uppermost ribs, being thus divided for the 
 transmission of the subclavian vessels. This mus- 
 cle may bend the neck ; but its chief use is to sup- 
 port the upper ribs, which is necessary to deter- 
 mine the contraction of the intercostal muscles 
 that way, and a ligament could not have done 
 this, because of the various positions that the neck 
 and back are liable to. 
 
 Serratus superior posticus arises with a thin ten- 
 don, inseparable from the rhomboides, from the 
 spinal process of the inferior cervical vertebra, and 
 the three superior of the thorax, and is inserted in- 
 to the second, third, and fourth ribs, immediately 
 beyond their bendings ; this, with the scalenus, sus- 
 tains the upper ribs, that they might not be pull- 
 ed downward by the depressors of the ribs in ex- 
 spiration, as the lower ribs are upward in inspi- 
 ratiom 
 
 Serratus inferior posticus arises with a broad 
 tendon, inseparable from that of the latissimus 
 dorsi, from the spinal processes of the three supe- 
 rior vertebrae of the loins, and two inferior of the 
 thorax, and is inserted into the tenth rib, but chief- 
 ly the ninth and eleventh : it pulls down the ribs in 
 exspiration. 
 
 Intercostales are eleven pair on each side, in 
 the interstices of the ribs ; from their situations 
 
OF THE MUSCLES. 
 
 103 
 
 distinguished into the external and internal ; they 
 all arise from the under edge of each rib, and are 
 inserted into the upper edge of the rib below. 
 The external are largest backward, having their 
 first beginnings from the transverse processes of the 
 vertebrae, like distinct muscles, which some call le- 
 vatores costarum. The internal run all from above 
 obliquely backward ; being thickest forward, and 
 thinnest toward the spine. These are also continu- 
 ed betwixt the cartilages of the sternum, with-fi- 
 bres perpendicular to the cartilages ; and between 
 the cartilages of the lowest ribs, they are insepa- 
 rable from the obliquus ascendens abdominis. These 
 muscles, by drawing the ribs nearer to each other, 
 pull them all upward, and dilate the thorax, they 
 being sustained at the top by the scalenus and ser- 
 ratus superior posticus. To these Mr. Cowper 
 adds some fleshy fibres, which run from one rib 
 over a second to a third, near the spine, which are 
 levatores costarum. 
 
 Triangularis sterni arises internally from the 
 cartilago ensiformis, and the lower edge of the os 
 pectoris, and is inserted into the end of the third, 
 fourth, fifth and sixth ribs. This pulls the ribs to 
 the bone of the sternum, and thereby bends its car- 
 tilages in exspiration. 
 
 Diaphragma arises, on the right side, by a pro- 
 cess from three lumbal vertebrae, and one of the 
 thorax ; and on the left, from the one superior of 
 the loins, and inferior of the thorax j this last part 
 
104 
 
 OF THE MUSCLES. 
 
 being less to give way to the great artery, and is- 
 inserted into the lower part of the sternum and the 
 five inferior ribs. The middle of this muscle is a 
 flat tendon, from whence the fleshy fibres begin 
 and are distributed, like radii, from a centre to a 
 circumference. When this muscle acts alone, it 
 constricts the thorax, and pulls the ribs downward, 
 and approaches toward a plane ; which action is 
 generally performed to promote the ejection of the 
 faeces. In large inspirations, when the intercostals 
 lift up the ribs to widen the thorax, this muscle 
 acts enough to bring itself toward a plane, without 
 overcoming the force of the intercostals, by which 
 means the breast is at once widened and lengthen- 
 ed : when it acts with the abdominal muscles, it 
 draws the ribs nearer together, and constricts the 
 thorax, and the superior force of the abdominal 
 muscles thrusting the parts of the lower belly against 
 it, it becomes at the same time convex upward, and 
 shortens the thorax, which occasions the largest 
 exspirations ; or acting alternately with the abdom- 
 inal muscles only, a more moderate inspiration and 
 exspiration is made by shortening and lengthen- 
 ing the thorax only, which is what we chiefly do 
 when lying down ; or acting alternately with the 
 intercostals only, a moderate exspiration and inspi- 
 ration is caused, by the widening and narrowing the 
 breast, which is what we are most prone to in an 
 erect position, the muscles of the abdomen at such 
 times being employed in supporting the parts con- 
 
OF THE MUSCLES. 
 
 105 
 
 tained in the abdomen. And though these mo- 
 tions of the ribs require at any one time but very 
 little force, the air within the thorax balancing that 
 without ; yet that these muscles, whose motions are 
 essential to life, may be never weary, the inspirators 
 in most men have force sufficient to raise mercury 
 in a tube four or five and twenty inches in an „ 
 erect posture, and the exspirators six or seven ; the 
 first of which will require about four thousand 
 pound force in most men, and the other propor- 
 tional. But I imagine, that lying down, these pro- 
 portions will differ by the weight of the parts con- 
 tained in the abdomen. In all the bodies I have 
 dissected, I have found the diaphragm convex up- 9 * 
 ward, which gave me occasion to think, that all 
 animals died in exspiration ; till the forementioned 
 experiment discovered, that the muscles of inspira- 
 tion were stronger than those of exspiration ; which 
 led me to make the following experiment. I cut 
 the wind-pipe of a dog, and having a string ready 
 fixed, I put a cork into it, and tied it fast instantly 
 after inspiration ; upon which I observed, that the 
 diaphragm, and the other muscles of inspiration and 
 exspiration, were alternately contracted and distend- 
 ed for some time ; but when he was dead, the ab- 
 dominal muscles were in a state of contraction, the 
 ribs were elevated to dilate the thorax, and the 
 diaphragm was convex upward. This experiment 
 also shews, that the diaphragm is not a muscle of 
 equal force either to the depressors or elevators of 
 
 p 
 
106 
 
 OF THE MUSCLES. 
 
 the ribs, it neither hindering the elevators from 
 raising the breast ; nor the depressors from thrust- 
 ing it upward, by compressing the parts contained 
 in the abdomen, though the breast was full of 
 air. 
 
 Sacer sacrolumbalis, longissimus dorsi, and semi- 
 spinalis, are all that portion of flesh betwixt the os 
 sacrum and the neck, which seeing there is no 
 membrane to distinguish it into several muscles, and 
 that it is all employed in the same actions, I shall 
 give it the name of extensor dorsi et lumborum, 
 and describe it all as one muscle. 
 
 Extensor dorsi et lumborum arises from the 
 upper part of the os sacrum, the spine of the os 
 ilium, the back parts of the lowermost vertebrae 
 of the loins, and remarkably from those strong ten- 
 dons which appear on their outsides. That part of 
 this muscle, which is known by the name of sacro- 
 lumbalis, is inserted into all the ribs near their ar- 
 ticulations, with the transverse processes of the ver- 
 tebrae, and into the transverse process of the last 
 vertebra of the neck ; besides, as this passes over 
 the ribs, it receives an origin from every rib, in a 
 manner that cannot well be described. The por- 
 tions of this muscle, which arise from the ribs, and 
 are inserted into the other ribs above, will necessa- 
 rily draw the back part of the ribs nearer together, 
 which must always be done as the back extends, 
 and independent of other actions of the thorax. 
 The next portion of this muscle, called longissimus 
 
0E THE MUSCLES. 
 
 1-07 
 
 dorsi, is inserted into all the transverse processes of 
 the vertebrae of the back, and partly into the ribs, 
 and the uppermost transverse processes of the verte- 
 brae of the loins ; and the upper end of it is neither 
 very distinct from the complexus of the head, nor 
 spinalis of the neck. The rest of this muscle, 
 known by the names of semispinalis, sacer, &c. 
 arises also from all the transverse and oblique pro- 
 cesses of the loins and back ; every portion, except 
 the lowermost, passing over live joints, is inserted 
 into the spinal process of the sixth vertebra above 
 its origin, all the way up the back, and at the 
 neck commences transversalis colli. This passing 
 of each portion of a muscle over a few joints, dis- 
 tributes their force equally enough among all these 
 joints, without the fibres being directed more ob- 
 liquely than those of penniform muscles ; but the 
 neck and loins not having sufficient provision of 
 this sort, there are small muscles between their pro- 
 cesses, which, though they are of little importance 
 for the motions of those parts, yet are sufficient to 
 distribute the force of larger muscles equally 
 among those joints ; and, besides the uses of the 
 extensor dorsi et lumborum, which its name im- 
 plies, it and its fellow alternately raise the hips in 
 walking, which any one may feel by laying his 
 hand upon his back. 
 
 Quadratus lumborum arises from the upper 
 part of the spine of the ilium, and is inserted in- 
 to all the transverse processes of the four upper- 
 
108 
 
 OF THE MUSCLES. 
 
 most lumbal vertebrae. This, and its fellow, act- 
 ing alternately, assist the last mentioned muscle in 
 raising the ossa innominata in progression : or each 
 acting singly, while the lower limbs are not moved, 
 inclines the body to one side. 
 
 Intertransversales lumborum, are small mus- 
 cles seated between all the transverse processes of 
 the vertebrae lumborum, to bring them nearer to- 
 
 Psoas parvus arises laterally from the body of 
 the first lumbal vertebra, and the lowest of the 
 back, and soon becoming a small tendon, is inserted 
 into the os pubis, near the ilium. It either assists 
 in bending the loins forward, or raising the os in- 
 nominatum in progressive motions. This muscle 
 is often wanting. 
 
 Psoas magnus arises laterally from the bodies 
 and transverse processes of the four superior ver- 
 tebrae of the loins, and the last of the back, and is 
 inserted with the following muscle into the lesser 
 trochanter. This bends the thigh, and when the 
 psoas parvus is wanting, this is larger. 
 
 Iliacus internus arises from the concave part 
 of the ilium, and from its lower edge, and passing 
 over the ilium, near the os pubis, joins the former 
 muscle, and is inserted with it, to be employed in 
 the same action. 
 
 Pectineus arises from the os pubis or pectinis, 
 near the joining of that bone with its fellow, and 
 is inserted into the linea aspera of the thigh bone. 
 
OF THE MUSCLES. 
 
 109 
 
 four fingers breadth below the lesser trochanter. 
 This bends the thigh, and turns the toes outward. 
 
 Triceps femoris. The two lesser heads of this 
 muscle arise under the pectineus, and the third 
 from the inferior edges and back part of the os 
 pubis and ischium, and is inserted into the whole 
 length of the linea aspera and the inner apophysis 
 of the os femoris. This also bends the thigh, and 
 turns the toes outward. When the thigh bone is 
 moved in a plane, which cuts at right angles a plane 
 that passes through the axis of either head of the 
 last muscle, that head rising lower than the centre 
 of motion of the hip joint, it will either assist the 
 flexors or extensors, and that most when the 
 bone has been moved most backward or forward : 
 and as either of these heads lie more or less out 
 of the said plane, they will give greater assistance 
 to that motion which is made on the side of the 
 said plane, contrary to their situation, and less on 
 the same side. This mechanism is frequently 
 made use of to make one muscle serve different 
 actions ; but I have only explained it in this in- 
 stance, because it is the most considerable one that 
 I know. 
 
 Cluteus maximus arises from the back part of 
 the spine of the ilium, and the dorsum ilii, and 
 side of the os coccygis and sacrum, and a ligament 
 extended between these bones, and from a thin 
 fascia, spread over that part of the following 
 muscle which this does not cover, and is inserted 
 
110 
 
 or THE MUSCLES. 
 
 by a strong tendon into the upper part of the linea 
 aspera of the thigh bone, and also into the flat ten- 
 don of the fascialis muscle, which insertion into, or 
 connexion with, that tendon, raises this muscle 
 farther from the centre of motion, and increases its 
 strength. This extends the thigh, and both these 
 together being contracted, occasionally assist the 
 levatores ani in supporting the anus. The breadth 
 of the origin and insertion of this muscle is very 
 observable ; for by that means, though it is the 
 largest muscle in the body, it is nevertheless right- 
 lined, without one fibre compressing another any 
 more than in penniform muscles. 
 
 Gluteus medius arises from all the anterior 
 part of the spina and dorsum ilii, and under part 
 of the last mentioned muscle, and is inserted into 
 the upper part of the great trochanter of the thigh 
 bone. This extends the thigh outward. 
 
 Gluteus minimus arises entirely under the for- 
 mer, from the dorsum ilii, and is inserted into 
 the upper and anterior part of the great trochanter 
 and neck of the thigh bone to extend the thigh. 
 
 Pyriformis arises internally from the inside of 
 the os sacrum, and growing, in more than half its 
 progress, into a round tendon, is inserted into the 
 upper part of the sinus, at the root of the great tro- 
 chanter. This assists somewhat in extending the 
 thigh, but more in turning it outward. 
 
 Quadratus femoris arises from the obtuse pro- 
 cess of the ischium, and is inserted into the up- 
 
OF THE MUSCLES. 
 
 Ill 
 
 per part of the linea aspera of the thigh bone, be- 
 tween the two trochanters. This draws the thigh 
 inward, and directs the toes outward. 
 
 Obturator internus or marsupialis arises gener- 
 ally from a strong membrane, or ligament, which 
 fills up the hole of the os innominatum, and 
 from the circumambient bone ; thence passing 
 over a channel in the ischium, betwixt its two 
 processes, it receives from them two other por- 
 tions, which are a sort of marsupium, and is insert- 
 ed into the sinus of the great trochanter. This 
 turns the thigh outward. 
 
 Obturator externus arises opposite to the for- 
 mer, from the outside of the os innominatum, and 
 is inserted into the sinus of the great trochan- 
 ter. This also turns the thigh outward. These 
 four last mentioned muscles acting with the ex- 
 tensors, prevent their turning the toes inward, and 
 in stepping forwards are continually acting to turn 
 the toes outwards ; for though the toes are placed 
 perpendicular to the front of the body, in taking 
 a long ftep, these muscles bring them perpendic- 
 ular to the side of the body ; and as these direct, 
 the same extensors will turn the thigh either out- 
 ward or backward, with their full force. 
 
 Fascialis, or membranosus, arises from the fore- 
 part of the spine of the ilium, and in about five 
 inches progress becomes a flat tendon, or fascia, 
 which is joined by a considerable detachment 
 from the tendon of the gluteus maximus, and 
 
112 
 
 OF THE MUSCLES. 
 
 from the Iinea aspera of the thigh bone, and 
 then covering in an especial manner the vastus 
 externus, is inserted at the top of the tibia and 
 fibula, and then proceeds to join the fascia, which 
 covers the upper part of the muscles situate on the 
 outside of the tibia, and from which a great part 
 of the fibres of those muscles arise. About the 
 middle of the leg it grows loose, and is so contin- 
 ued to the top of the foot, being connected there, 
 and at the lower part of the leg, to the ligaments 
 which tie down the tendons. This tendon, where 
 it covers the vastus externus, receives additional 
 transverse fibres, which run through the thigh, 
 but are most conspicuous on the outside. This 
 draws the thigh outward, and passing over the 
 knee forwarder than its axis of motion, it will 
 help to extend that joint. 
 
 Gracilis arises from the os pubis, close to the 
 penis, and is inserted into the tibia, four or five 
 fingers breadth below the knee. This draws the 
 thigh inward, and passing over the knee, behind 
 its axis of motion, it will help to bend it. 
 
 Sartorius arises from the fore part of the spine 
 of the ilium, and thence descending obliquely 
 to the inside of the tibia, is there inserted four or 
 five fingers breadth below the joint. This at once 
 helps to bend both the thigh and leg, particularly 
 the thigh, at very long levers ; it directly helps to 
 lift up the leg in walking up stairs, or laying the 
 legs across, like taylors. 
 
OF THE MUSCLES. 
 
 113 
 
 Semitendinosus arises from the obtuse process 
 of the ischium, and growing a round tendon in 
 somewhat more than half its progress, is inserted 
 near the former muscles into the tibia : it helps to 
 extend the thigh and bend the tibia. 
 
 Semimembranosus arises by a flat tendon like 
 a membrane from the obtuse process of the is- 
 chium, and being continued tendinous betwixt the 
 bellies of the last mentioned and following muscles, 
 and then growing fleshy, becomes again tendinous 
 above the joint, and is inserted nearer the joint 
 than the former muscle for the same use. 
 
 These two make the internal hamstring, and 
 arising and inserting so near together, they might 
 have been one muscle, but their fibres would have 
 been near twice as long, which would have given 
 a motion near twice as quick, but not so strong, 
 unless it had been inserted at a distance from the 
 joint it moves proportionable to its length, which 
 could not well be ; therefore they are made two 
 muscles of a number of fibres nearly equal to what 
 one could have been, and are inserted at distances 
 from the axis of motion of the knee, proportional 
 to the different lengths of their fibres in the direc- 
 tions of their axis. 
 
 Biceps tibiae, the first head arises in common 
 with the two preceding muscles, from the obtuse 
 process of the ischium ; the second from the lower 
 part of the linea aspera of the thigh bone. This 
 soon joins the former, and is inserted with it into 
 
 Q 
 
114 
 
 OF THE MUSCLES. 
 
 the upper part of the fibula to bend the leg, and 
 the first head also extends the thigh. The tendon 
 of this muscle makes the external hamstring, when 
 the knee is bent ; and when we sit down, the bi- 
 ceps will turn the leg and toes outward, and the 
 semitendinosus and semimembranosus will turn 
 them inward. 
 
 Popliteus arises from the outer apophysis of the 
 os femoris, and thence running obliquely inward, 
 is inserted into the tibia immediately below its head. 
 This assists the flexors, and draws the tibia toward 
 the outer apophysis of the thigh bone. 
 
 Rectus tibiae arises with a tendon from the upper 
 part of the acetabulum of the os innominatum, and 
 by another tendon, which is a sort of ligament to 
 this, from a processus innominatus of the ilium be- 
 low its spine forward, and is inserted, together with 
 the three following muscles, into the patella. It 
 | bends the thigh, and extends the tibia. 
 
 Vastus externus arises from the anterior part 
 of the great trochanter and upper part of the li- 
 nea aspira of the thigh bone, and is inserted into 
 the upper and external part of the patella. It ex- 
 tends the tibia.. 
 
 Vastus internus arises from the inner and 
 lower part of the linea aspera, and is inserted into 
 the upper and inner part of the patella, to extend 
 the tibia ; and the fibres of this muscle being ob- 
 lique, it keeps the patella in its place, the other 
 muscles lying in the direction of the os femoris-, 
 
OF THE MUSCLES. 
 
 115 
 
 which makes an obtuse angle with the tibia, they 
 would alone be liable to draw the patella outward. 
 This contrivance is most obvious in those whose 
 knees bend most inward. 
 
 Crureus arises between the two last, below the 
 rectus, from all the convex part of the os femoris, 
 and is inserted in like manner into the patella ; the 
 patella being tied down by a strong ligament to the 
 tibia. These three last muscles extend the tibia 
 only, and might very properly be called extensor 
 tibiae triceps. 
 
 Gasterocnemius arises by two small beginnings 
 above the back part of the apophysis of the os 
 femoris, which soon becoming large bellies unite, 
 and then become a flat tendon which joins the fol- 
 lowing muscles to be inserted into the os calcis. 
 The two parts of this muscle are by some writers 
 distinguished into two muscles. Its use is to extend 
 the tarsus and bend the knee. 
 
 Plantaris arises under the outer beginning of 
 the last named muscle, from the external apophysis 
 of the os femoris, and soon becoming a small ten- 
 don, is so continued betwixt the foregoing and sub- 
 sequent muscles, and is inserted with them. It 
 bends the knee, and extends the tarsus. Authors 
 derive the tendinous expansion on the bottom of 
 the foot from the tendon of this muscle ; but seeing 
 the expansion is much more than this tendon could 
 make, and that this tendon can be traced no far- 
 ther than the os calcis, and that the expansion is 
 
116 
 
 OF THE MUSCLE&. 
 
 as large when the muscle is wanting, which is not 
 seldom, I cannot be of that opinion. 
 
 Gasterocnemius internus arises from the upper 
 part of the tibia, and one third of the fibula, below 
 the popliteus, and is inserted with the two fore- 
 going muscles by a strong tendon into the upper 
 and back part of the os calcis. This muscle only ex- 
 tends the tarsus. 
 
 Tibialis anticus arises from the upper and ex- 
 terior part of the tibia, and is inserted laterally 
 into the os cuneiforme majus of the tarsus, and by 
 a small portion of its tendon into the metacarpal 
 bone of the great toe. This bends and turns the 
 tarsus inward. 
 
 Tibialis posticus arises first by a small begin- 
 ning from the upper part of the tibia between that 
 bone and the fibula, then passing between the 
 bones through a perforation in the transverse liga- 
 ment which connects those bones, it takes other be- 
 ginnings from the upper and middle part of the ti- 
 bia, and from the middle of the fibula, and the 
 ligament betwixt the tibia and fibula ; then grow- 
 ing a round tendon, passes under the inner ancle, 
 and is inserted into the lower part of the os navicu- 
 lare, and into the os cuneiforme majus. This ex- 
 tends and turns inward the tarsus. 
 
 Peroneus longus arises from the upper and 
 outer part of the fibula, and growing a tendon to- 
 ward the lower part of this bone, passes under the 
 outer ancle, and the muscles situated on the bot- 
 
or THE MUSCLES. 
 
 117 
 
 tom of the foot, and is inserted into the beginning 
 of the metatarsal bone of the great toe, and the 
 os cuneiforme next that bone. This turns the 
 tarsus outward, and directs the force of the other 
 extensors of the tarsus toward the ball of the great 
 toe. 
 
 Peroneus brevis arises from the middle of the 
 fibula, under a part of the former, and growing- 
 tendinous, passes under the outward ancle, and is 
 inserted into the beginning of the upper part of 
 the os metatarsi of the little toe, and sometimes 
 bestows a small tendon on the little toe. Its use is 
 to extend the tarsus, and turn it outward. 
 
 These two last muscles riding over the lower 
 end of the fibula, are often the cause of a sprain in 
 the outer ancle, when they are vehemently exert- 
 ed to save a fall. 
 
 Extensor pollicis longus arises from the upper 
 and middle part of the fibula and the ligamentum 
 transversale, and soon becoming a strong tendon, 
 is inserted into the last bone of the great toe. 
 This also bends the tarsus with a much longer 
 lever than it extends the toe. 
 
 Extensor pollicis brevis arises from the fore part 
 of the os calcis, and is inserted into the same place 
 with the former. 
 
 Flexor pollicis longus arises from the fib- 
 ula, opposite to the extensor longus, and then 
 passing under the inner ancle, is inserted into the 
 under side of the last bone of the great toe. This 
 
118 
 
 OF THE MUSCLES. 
 
 extends the tarsus at a longer lever than it bends 
 the toe. 
 
 Flexor brevis and adductor pollicis are the same 
 muscle, arising from the two lesser ossa cuneiformia. 
 and os cuboides and calcis. They are inserted 
 into the ossa sesamoidea, which are tied by a 
 ligament to the first bone of the great toe, reckon- 
 ing only two bones to the great toe. These mus- 
 cles bend the great toe. 
 
 Abductor pollicis arises pretty largely from 
 the inner and back part of the os calcis, and by 
 a smaller beginning from the os naviculare ; 
 thence passing forward contiguous to the os cu- 
 neiforme majus, passes by the external sesamoid 
 bone of the great toe to its insertion into the first 
 bone of the great toe. This muscle is less an ab- 
 ductor than a flexor pollicis pedis ; it also very 
 much helps to constrict the foot lengthways. 
 
 Transversalis pedis arises from the lower end of 
 the metatarsal bone of the toe next the least, and 
 is inserted into the internal sesamoicl bone. This 
 truly is an adductor of the great toe, and helps to 
 keep the constricture of the bottom of the foot. 
 
 Extensor digitorum pedis longus arises acute 
 from the upper part of the tibia, and from the 
 upper and middle part of the fibula and ligament 
 between these bones ; then dividing into five 
 tendons, four of them are inserted into the second 
 bone of each lesser toe, and the fifth into the be- 
 ginning of the metatarsal bone of the least toe, and 
 
er THE MUSCLES. 
 
 119 
 
 sometimes by a small tendon also into the little toe. 
 This last portion for the most part is separate from 
 its beginning, and may be accounted a distinct mus- 
 cle. The four first tendons only of this muscle ex- 
 tend the toes, but all five bend the tarsus, and that 
 with a longer lever than any of them bend a toe. 
 
 Extensor digitorum brevis, arises together 
 with the extensor pollicis brevis, from the os cal- 
 cis, and dividing into three small tendons is insert- 
 ed into the second joint of the three toes next 
 the great one. The long extensors of the toes serve 
 not only to extend them, but also contribute to 
 the bending of the ancle, which motions are usu- 
 ally performed together in progression ; but the 
 short extensors arising below the ancle, extend the 
 toes only ; and when the long extensors are em- 
 ployed for that action only, the extensors of the 
 tarsus must act at the same time, to prevent the 
 bending of the ancle. This is the reason why the 
 toes have need, though their motions are less, of 
 more extensors than the fingers. 
 
 Flexor brevis or perforatus arises from the 
 under and back part of the os calcis, thence pass- 
 ing toward the four lesser toes, divides into four 
 tendons, which are inserted into the beginning of 
 the second bone of each of the lesser toes. These 
 tendons are divided to let through the tendons of 
 the following muscles. 
 
 Flexor longus or perforans arises from the 
 back part of the tibia, above the insertion of 
 
120 
 
 OF THE MUSCLES. 
 
 the popliteus, and part of the fibula ; thence de- 
 scending under the os calcis to the bottom of the 
 foot, there becomes tendinous, often crosses, and, 
 in most bodies, communicates with the flexor Ion- 
 gus pollicis pedis ; then it divides into four ten- 
 dons which pass through those of the flexor brevis, 
 and are inserted into the third bone of the four 
 lesser toes. This muscle also extends the tarsus. 
 The second beginning of this muscle arises from the 
 os calcis, and joins the tendons where they divide. 
 This portion only bends the toes : and seeing the 
 flexor; longus of the toes will, when it acts alone, 
 extend the tarsus as well as bend the toes, this 
 portion, like the short extensors of the toes, seems 
 purposely contrived to bend the toes alone. 
 
 Lumbricales arise from the tendons of the per- 
 forans, and are inserted into the first bone of each 
 of the lesser toes which they bend. 
 
 Abductor minimi digiti pedis arises by the per- 
 foratus from the os calcis, and being part of it in- 
 serted into the metacarpal bone of the least toe, it 
 receives another beginning from the os cuboides, 
 and is inserted into the first bone of the least toe, 
 which it bends and pulls outward, and very much 
 helps to constrict the bottom of the foot. 
 
 Abductor secundus minimi digiti arises under 
 the former muscle from the metatarsal bone, and is 
 inserted into the little toe. 
 
 Interossei are seven muscles which lie like 
 those of the hands,- and arise like them from the 
 
OF THE MUSCLES. 
 
 121 
 
 metatarsal bones, and are inserted like them into 
 the last joints of the four lesser toes ; and being in 
 their progress attached to the tendons 1 which ex- 
 tend the second joints of the toes, they will extend 
 both these joints. These muscles may be fitly di- 
 vided into external and internal ; the internal also 
 bend the first joints, as do all the interossei in the 
 hand, but here the outer ones extend the first joints ^ 
 and if we consider that the first of these muscles is 
 analogous to the abductor indicis of the hand, and 
 that the abductor minimi is alike in both, we find 
 that the muscles to move the fingers and lesser 
 toes sideways are alike in number, though this mo- 
 tion of the toes is in a manner lost from the use of 
 shoes. The muscles that bend or extend the last 
 joints of the toes will also move the second and 
 first, and those that move the second will also 
 move the first, as they do ija the fingers. 
 
122 
 
 TABLES. 
 
 TABLE XL 
 
 1 Musculus frontalis. 
 
 2 Temporalis. 
 
 3 Orbicularis. 
 
 4 The parotid gland, with its duct, which passes* 
 
 through the buccinator. 
 
 5 Mastoideus. 
 
 6 Zygomaticus. 
 
 7 Elevator labii superioris proprius. 
 
 8 Elevator labiorum communis. 
 
 9 Depressor labiorum communis. 
 
 10 Sphincter oris. 
 
 1 1 Depressor labii inferioris proprius. 
 
 12 Buccinator. 
 
 13 Sterno-hyoidei. 
 
 14 Coraco-hyoideus. 
 
 15 Mastoideus. 
 
 16 Trapezius. 
 
 17 Pectoralis. 
 
 18 Deltoides. 
 
'' 
 
 TAB. XL 
 
 JP-12,2,. 
 

 
 
 
'CAB.XIC. 
 
tabi.es. 
 
 TABLE XIL 
 
 1 Musculus mastoideus. 
 
 2 Pectoralis. 
 
 3 Biceps flexor cubitL 
 
 4 Coraco-brachialis. 
 
 5 Triceps extensor cubitL 
 
 6 Latissimus dorsL 
 
 y Serator major anticus, 
 
 8 Obliquus descendens abdominis? 
 
 9 Rectus abdominis. 
 
 10 Pyramidalis. 
 
 11 Sartorius. 
 
 12 Fascialis. 
 
 13 Rectus femoris. 
 
124 
 
 TABLES. 
 
 TABLE XIII. 
 
 1 Trapezius. 
 
 2 Deltoides. 
 
 3 Infraspinatus scapulae. 
 
 4 Teres major. 
 
 5 Rhomboides. 
 
 6 Latiksimus dorsi. 
 
 7 Glutaei. 
 
 8 Obliquus descendens abdominis. 
 
 i 
 
T,\B.Xni. 
 
 -P. jst4 
 
TAB-XIV. 
 
TABLES. 
 
 125 
 
 TABLE XIV. 
 
 1 Musculus deltoides. 
 
 2 Triceps extensor cubiti. 
 
 3 Anconseus. 
 
 4 Extensor carpi radialis primus. 
 
 5 Extensor carpi radialis secundus. 
 
 6 Extensor carpi ulnaris. 
 
 7 Flexor carpi ulnaris. 
 
 8 Deltoides. 
 
 9 Biceps flexor cubiti. 
 
 10 Brachiaeus internus. 
 
 11 Triceps extensor cubiti. 
 
 12 Supinator radii longus. 
 
 13 Extensores carpi radiales. 
 
 14 Extensor communis digitorum. 
 
 15 Extensor carpi ulnaris. 
 
 16 Flexor carpi ulnaris. 
 
 17 Anconseus. 
 
 18 Extensor pollicis primus. 
 
 19 Extensor pollicis secundus. 
 
126 
 
 TABLES- 
 
 TABLE XV. 
 
 1 Musculus deltoides. 
 
 2 Pectoralis. 
 
 3 Biceps flexor cubiti. 
 
 4 Triceps extensor cubiti. 
 
 5 The fascia tendinosa of the biceps muscle. 
 
 6 Supinator radii longus. 
 
 7 Flexor carpi radialis. 
 
 8 Glutseus. 
 
 9 Vastus externus. 
 
 10 Biceps femoris. 
 
 11 Semitendinosus. 
 
 12 Semimembranosus. 
 
 13 Gastrocnemius. 
 
 14 Solaeus. 
 
TABLES. 
 
 12 
 
 TABLE XVL 
 
 1 Musculus rectus femoris. 
 
 2 Vastus externus. 
 
 3 Vastus internus, 
 
 4 Sartorius. 
 
 5 Pectinaeus. 
 
 6 The large head of the triceps, 
 ,7 Gastrocnemius. 
 
 8 Solaeus. 
 
 9 Membranosus. 
 
 10 Rectus femoris. 
 
 11 Vastus internus. 
 
 12 Vastus externus. 
 
 13 Sartorius. 
 
 14 Pectinaeus. 
 
 15 Gastrocnemius. 
 
 16 Solaeus. 
 
 17 Tibialis anticus. 
 
 18 Extensores digitorum 
 
128 
 
 tabIes* 
 
 TABLE XVII, 
 
 1 Musculus abductor pollicis. 
 
 2 Adductor pollicis. 
 
 3 Flexor brevis. 
 
 4 Quadratus seu palmaris brevis. 
 
 5 The strong ligament of the carpus that binds 
 down the tendons of the flexors of the fingers. 
 
 6 Abductor minimi digiti. 
 
 7 A probe under the tendons of the perforatus. 
 
 8 A probe under the tendons of the perforans. 
 
 9 Lumbricales. 
 
 10 Perforatus. 
 
 11 Flexor carpi radialis. 
 
 12 Flexor carpi ulnaris. 
 
TAB.XYir. 
 
 P. ;z8. 
 
TAB.WflL 
 
TABLES. 
 
 129 
 
 TABLE XVIIL 
 
 1 Tendo achilles. 
 
 2 That part of the astragalus which articulates 
 
 with the tibia. 
 
 3 The tendon of the tibialis anticus. 
 
 4 The tendon of the extensor pollicis pedis longus, 
 
 5 The tendons of the extensor digitorum com- 
 
 munis. 
 
 6 Extensor pollicis pedis brevis. 
 
 7 Extensor digitorum brevis. 
 
 8 The union of the tendons of the extensor lortgus 
 
 and the extensor brevis. 
 
130 
 
 TABLES. 
 
 TABLE XIX. 
 
 1 Musculus triceps extensor cubitL 
 
 2 Deltoides. 
 
 3 Teres major. 
 
 4 Latissimus dorsi. 
 
 5 Pectoralis. 
 
 6 Obliquus descendens abdominis. 
 
 7 Rectus abdominis. 
 
 8 Sartorius. 
 
 9 Rectus femoris. 
 
 10 Vastus externus. 
 
 11 Vastus internus. 
 
 12 Gastrocnemius. 
 
 13 Solaeus. 
 
 14 Tibialis anticus. 
 
TAE.XIX. 
 
 130 ■ 
 
- 4 
 
 TAB . XX . 
 
 P. isi . 
 
TABLES, 
 
 131 
 
 TABLE XX. 
 
 This table is done after the famous statue of 
 Hercules and Antaeus. The muscles here exhib- 
 ited being all explained in the other plates, the 
 figures are omitted to preserve the beauty of the 
 plate. 
 
THE 
 
 ANATOMY 
 
 OF THE 
 
 HUMAN BODY. 
 
 BOOK III. 
 
 CHAPTER I. 
 
 OF THE EXTERNAL PARTS, AND COMM0N IN- 
 TEGUMENTS. 
 
 Tm vulgar names of the external parts 
 of the human body being sufficiently known 
 for the description of any disease or operation 5 I 
 shall only describe those which anatomists have 
 given for the better understanding of the sub-con- 
 tained parts. 
 
 The hollow on the middle of the thorax, under 
 the breasts, is called scrobiculus cordis ; the middle 
 of the abdomen for about three fingers breadth 
 
134 
 
 EXTERNAL PARTS, &C. 
 
 above and below the navel, is called regio um- 
 bilicalis ; the middle part above this, epigas- 
 
 cartilages of the lower ribs, hypocondrium ; and 
 from below the regio umbilicalis, down to the ossa 
 ilia and ossa pubis, hypogastrium. 
 
 Caticula, or scarf-skin, is that thin insensible 
 membrane which is raised by blisters in living 
 bodies. It is extended over every part of the true 
 skin, unless where the nails are. It appears to me 
 in a microscope a very fine smooth membrane, only 
 unequal where the reticulum mucosum adheres 
 to it. Lewenhoeck, and others, say it appears 
 scaly, and compute that a grain of sand of the 
 hundreth part of an inch diameter, will cover 
 two hundred and fifty of these scales, and that each 
 scale has about five hundred pores ; so that a grain 
 of sand will cover 125,000 pores through which 
 we perspire. Its use is to defend the true skin that 
 it may not be exposed to pain from whatever it 
 touches ; and also to preserve it from wearing ; 
 it is thickest on those parts of the bottom of the 
 foot which sustain the body, and in hands much 
 used to labour, being so contrived as to grow the 
 thicker the more those parts are used. In scorbu- 
 tic disorders the cuticula will sometimes become 
 scurfy and full of little ulcers, which are apt to 
 remain even when the cause is taken away, but the 
 cuticle being taken oft by a blister, the new cuti-c 
 cle will be sound ; and though the cutis is affected, 
 
135 
 
 EXTERNAL parts, &c. 
 
 and full of little tumors, the discharge of the blis- 
 ter will often cure them also. 
 
 Between this and the true skin is a small 
 quantity of slimy matter, which was supposed by 
 Malpighi and others, to be contained in proper 
 vessels, interwoven with one another, and there- 
 fore by them named reticulum mucosum. It is 
 most considerable where the cuticula is thickest, 
 and is black, white, or dusky, such as is the com- 
 plexion ; the colour of this and the cuticula being 
 the only difference between Europeans and Afri- 
 cans or Indians, the fibres of the true skin being 
 white in all men ; but the florid colour of the 
 cheeks is owing to the blood in the minute vessels 
 of the skin, as that in the lips to the vessels in the 
 muscular flesh ; for the cuticula being made of 
 excrementitious matter, has no blood vessels. 
 
 Cutis, or true skin, is a very compact, strong, 
 and sensible membrane, extended over all the 
 other parts of the body, having nerves terminat- 
 ing so plentifully in all its superficies, for the 
 sense of touching, that the finest pointed instru- 
 ment can prick no where without touching some 
 of them. These nerves are said by Malpighi 
 and others, who have examined them carefully, to 
 terminate in small pyramidal papilke ; nevertheless, 
 it seems that a plain superficies of the skin is much 
 fitter and more agreeable to what we experience of 
 this sensation ; for a plain superficies exposing all 
 the nerves alike, I think, would give a more equal 
 
136 EXTERNAL PARTS, &C. 
 
 sensation, while nerves ending in a pyramidal pa- 
 pilla would be exceeding sensible at the vertex of 
 that papilla ; and those at the sides and round the 
 base, which would be far the greatest part, would 
 be the least useful. Immediately under the skin 
 upon the shin bone, I have twice seen little tumors 
 less than a pea, round and exceeding hard, and so 
 painful that both cases were judged to be cancerous ; 
 they were cured by extirpating the tumor : but 
 what was more extraordinary, was a tumor of this 
 kind, under the skin of the buttock, small as a 
 pin’s head, yet so painful that the least touch 
 was insupportable, and the skin for half an inch 
 round was emaciated ; this too I extirpated, with 
 so much of the skin as was emaciated, and some 
 fat. The patient, who before the operation could 
 not endure to set his leg to the ground, nor turn 
 in his bed without exquisite pain, grew immediately 
 easy, walked to his bed without any complaint, and 
 was soon cured. 
 
 Glanduke miliares are small bodies like mil- 
 let seeds, seated immediately under the skin in the 
 axillas ; and are said to have been found under all 
 other parts of the skin, where they have been 
 looked for with microscopes. These glands are 
 supposed to separate sweat ; which fluid was thought 
 to be only the materia perspirabilis flowing in a 
 greater quantity, and condensed, till San c torius 
 assured us that it is not so, and that more of the 
 materia perspirabilis is separated in equal times than 
 
137 
 
 external parts, &c. 
 
 of sweat ; of the former, he says, usually fifty-two 
 ounces a day in Italy, where his experiments were 
 made, and of the latter not near so much in the 
 most profuse sweats ; which seems to favour the 
 opinion of the existence of these glands : but who- 
 ever reads Mr. Hales’s experiments will find, 
 that what Sanctorius accounted for by an 
 imaginary insensible perspiration, different from 
 that which in the greatest degree produces sweat, 
 is really made by the lungs in respiration, and is 
 ten times more than all the ordinary perspiration 
 through the cutis, and seems to be but the same 
 kind of fluid discharged both ways ; for whenever 
 it is interrupted through the skin in cold weather, 
 then the lungs are overcharged, which occasions i** 2 
 coughing to get rid of it, which in a greater 
 degree is an asthma. Hence too it is, that those 
 who perspire most in the summer are most sub- 
 ject to asthmatic disorders in the winter ; and most 
 of all so, when the air they breathe is fullest of 
 vapour, and therefore least capable of conveying 
 this matter from the lungs. That this kind of 
 perspiration is very great, is sufficiently shewn by 
 breathing upon glass, or any thing that is smooth 
 and cold. 
 
 Membrana adiposa is all that membrane imme- 
 diately under the skin, which contains the fat 
 in cells ; it is thickest on the abdomen and but- 
 tocks, and thinnest nearest the extremities ; and 
 where the muscles adhere to the skin, and on the 
 
 T 
 
138 
 
 EXTERNAL PARTS, &C, 
 
 penis, little or none. It contributes to keep tke in 
 ncr parts warm, and by filling the interstices of 
 the muscles, renders the surface of the body smooth 
 and beautiful, and may serve to lubricate their sur- 
 faces. Whether the decrease of fat, which often 
 follows labour or sickness, proceeds from its being 
 reassumed into the blood vessels, or whether it is 
 constantly perspiring through the skin, and the 
 lessening of its quantity is from the want of a sup- 
 ply equal to its consumption, is with me a matter 
 of doubt, though the former opinion, I know, gen- 
 erally prevails. The cells of this membrane com- 
 municate throughout the whole body so much, 
 that from any one part the whole may be filled 
 with air. I have seen two cases where the wind- 
 pipe being cut, and the external wounds being 
 closely stitched by injudicious surgeons, the air 
 that escaped at the wound of the wind-pipe get- 
 ting into the cells of the membran-a adiposa, blew 
 up the upper part of the body like a bladder. 
 The like accident I have seen from a broken rib, 
 where, I suppose, the end of the rib had pricked 
 the lungs ; all these persons died. In these cells 
 the water is contained in an anasarca, which from 
 its weight, first fills the depending parts, as the 
 air in the former cases did the upper parts ; and 
 when these cells are very full, the water frequently 
 passes from them into the abdomen, and after 
 tapping, though the limbs were ever so full, 
 they will almost empty themselves in one night’s 
 
EXTERNAL PARTS, &C. 139 
 
 time. This membrane is the usual seat of im= 
 posthumations and boils, in both which nature, 
 uninterrupted, always corrodes a hole in the skin ; 
 from whence we may learn, that the best way of 
 opening any imposthumation is by a hole, and that 
 too as near the time of its breaking naturally as 
 may be, that nature may make the utmost ad- 
 vantage of the discharge. There is sometimes a 
 large kind of boil or carbuncle in this membrane, 
 which first makes a large slough and a number of 
 small holes through the skin, which in time mor- 
 tifies and casts off, but the longer the slough is 
 suffered to remain, the more it discharges, and the 
 more advantage to the patient ; at the latter end of 
 which case the matter has a bloody tincture, and a 
 bilious smell, exactly like what comes from ulcers 
 in the liver ; and both these cases are attended with 
 sweet urine, as in a diabetes. 
 
 Mammae, the breasts, seem to be of the same 
 structure in both sexes, but largest in women. 
 Each breast is a conglomerate gland to separate 
 milk, with its excretory ducts ; which are capable 
 of very great distention, tending toward the nipple, 
 which as they approach, they unite, and make but 
 a few ducts at their exit. There are to be met 
 with in authors instances attested of men mvina: 
 suck, when they have been excited by a vehement 
 desire of doing it and it is a common observation, 
 that milk will flow out of the breasts of new-born 
 children, both male and female. 
 
140 EXTERNAL PARTS, &C. 
 
 The breasts and uterus in women, the tongue, 
 mouth, and penis in men, and the eyes in chil- 
 dren, are the parts most subject to cancers ; yet 
 there is no part where this disease has not some- 
 times fixed. It is a matter of dispute among some 
 surgeons, whether cancerous tumours should ever be 
 extirpated or not, though it is certain none of these 
 ever were cured without, and being extirpated, 
 there have been many. The objection against ex- 
 tirpation is this, that the operation often provokes 
 the part, which otherwise might lie quiet : but I 
 do not think this is true ; in desperate cases, where 
 we cannot extirpate, we find the best remedy is 
 plentiful bleeding, (which also is nature’s last resort) 
 gentle constant evacuations by stool, and a vegeta- 
 ble diet ; and though physic never cures while the 
 tumour remains, yet after extirpation it is highly 
 useful, and even the worst constitutions have some- 
 times been brought to their primitive state. An 
 eminent surgeon in the city, having a patient with 
 a cancerated breast, extremely large, and so much 
 ulcerated that the stench of it was insupportable ; 
 she insisted upon the extirpation, against all advice, 
 with no other hopes but to be delivered from the 
 offensive smell. Some time after the operation, the 
 wound looking extremely sordid, he sprinkled it 
 all over with red mercury precipitate, which put 
 the patient into a high salivation, upon which the 
 breast grew clean and healed, the patient recover- 
 ed, and, contrary to all expectation, lived many 
 
membranes in general. 
 
 141 
 
 years in good health. From this accident I learnt 
 the usefulness of salivating, after extirpating can- 
 cerous tumours, though nothing is more hurtful be- 
 fore. In the extirpation of a breast, and all other 
 tumours, as much skin as is possible should be sav- 
 ed ; for the loss of a great deal of skin is sufficient 
 to make an incurable ulcer in the most healthful 
 body, and much more so in a bad constitution. 
 
 CHAPTER II. 
 
 OF THE MEMBRANES IN GENERAL. 
 
 Every distinct part of the body is covered, 
 and every cavity is lined with a single mem- 
 brane, whose thickness and strength is as the bulk 
 of the part it belongs to, and as the friction to 
 which it is naturally exposed. 
 
 Those membranes that contain distinct parts, 
 keep the parts they contain together, and render 
 their surfaces smooth, and less subject to be lace- 
 rated by the actions of the body ; and those which 
 line cavities serve to render the cavities smooth, and 
 fit for the parts they contain to move against. 
 
 The membranes of all the cavities that contain 
 solid parts, are studded with glands, or are provided 
 with vessels, which separate a mucus, to make the 
 parts contained move glibly against one another, 
 and not grow together ; and those cavities which 
 are exposed to the air, as the nose, ears, mouth. 
 
142 
 
 SALIVARY GLANDS. 
 
 and trachea arteria, have their membranes beset 
 with glands which separate matter to defend them 
 from the outer air. Those membranes that have 
 proper names, and deserve a particular description, 
 will be treated of in their proper places. 
 
 CHAPTER III. 
 
 OF THE SALIVARY GLANDS. 
 
 Parotis, or maxillaris superior, is the larg- 
 est of the salivary glands ; it is situate behind 
 the lower jaw, under the ear ; its excretory duct 
 passes over the upper part of the masseter mus- 
 cle, and enters the mouth through the bucci- 
 nator. This gland has its saliva promoted by the 
 motions of the lower jaw. Its duct passes over the 
 tendinous part of the masseter muscle, that it may 
 not be compressed by that muscle, which would 
 obstruct the saliva in it, though it is frequently said 
 that it passes over that muscle that it may be com- 
 pressed by it, to promote the saliva. In sheep, 
 horses, &c. whose jaws are long, this muscle is in- 
 serted far from the centre of motion, that the end 
 of the jaw may be moved with sufficient strength, 
 and that distant insertion requiring a greater length 
 of muscle, that its motion may be quick enough, 
 no part of this muscle could be allowed to be ten- 
 dinous ; therefore, it seems, to avoid the inconve- 
 
SALIVARY GLANDS. 
 
 143 
 
 
 r 
 
 nience of compression from the muscle, the duct in 
 those animals goes quite round the lower end of it. 
 When this duct is divided by an external wound, 
 the saliva will flow out on the cheek, unless a con- 
 venient perforation be made into the mouth, and 
 then the external wound may be healed. I have 
 seen patients with this gland ulcerated, from which 
 there was a constant effusion of saliva, till the 
 greatest part of the gland was consumed with red 
 mercury precipitate ; and then they healed with little 
 trouble. Hildanus mentions the same case, which 
 for two years had been under the care of a surgeon 
 without success ; and was at last cured by the ap- 
 plication of an actual cautery. 
 
 Maxillaris inferior is situate between the low- 
 er jaw and the tendon of the digastric muscle. 
 Its duct passes under the musculus mylohyoideus, 
 and enters the mouth under the tongue, near the 
 dentes incisorii. I was at the opening of a woman 
 who was suffocated by a tumour which begun in this 
 gland, and extended itself from the sternum to the 
 parotid gland on one side in six weeks time, and in 
 nine weeks killed her ; it was a true scirrhus, and 
 weighed twenty six ounces. In a man which I 
 dissected, I found a quantity of pus near this gland, 
 and a bundle of matter not unlike hair, as large as 
 an hen’s egg. 
 
 Sublingualis is a small gland situated under the 
 tongue, between the jaw and the seratoglossus 
 muscle. In a calf I found several ducts of this 
 
144 
 
 SALIVARY GLANDS'. 
 
 gland filled by an injection into the duct of the 
 submaxillary gland ; but Morgagni and others 
 shew, that the ducts of this gland enter the mouth 
 directly from the gland in several places near the 
 grinding teeth. 
 
 Tonsilla is a globular gland, about the bigness 
 of a hazel nut, situate upon the pterygoideus in- 
 ternus muscle, between the root of the tongue and 
 the uvula. It has no duct continued from it, but 
 empties all its small ducts into a sinus of its own, 
 which sinus, when the gland is inflamed, may ea- 
 sily be mistaken for an ulcer. This gland with its 
 fellow direct the masticated aliment into the pha- 
 rynx, and also serve for the uvula to shut down 
 upon when we breathe through the nose. They are 
 compressed by the tongue and the aliment, when 
 the former raises the latter over its root, and there*- 
 by opportunely emit their saliva to lubricate the 
 food for its easier descent through the pharynx. A 
 scirrhous tumour of either of these glands is a com- 
 mon disease, and it admits of no remedy but ex- 
 tirpation. The best way of extirpating them, is, 
 I think, by ligature : if the gland is small at its 
 basis, the ligature may be tied round it, which I 
 have often performed by fixing the ligature to the 
 end of a probe bent, and so drew it round the 
 gland, and tied it ; and in a few days the glands 
 dropped off : but meeting with other cases of this 
 kind, where the basis of the gland was too large to 
 tie, I contrived an instrument like a crooked needle 
 
SALIVARY GLANDS. 
 
 145 
 
 set in a handle, with an eye near the point ; I thrust 
 this instrument, with a ligature into it through the 
 bottom of the gland, and then taking hold of the 
 ligature with a hook, I drew back the instrument ; 
 then drawing the double ligature forwards, I divid- 
 ed it, and tied one part above and the other below, 
 in the same manner that I did to extirpate part of 
 the omentum in the cure of an hernia, and this 
 succeeded as well as the former. See the plate at 
 the latter end of this book. 
 
 Pressure upon the surface of a gland very 
 much promoting the secretion that is made in it, 
 these glands are so seated as to be pressed by the 
 lower jaw, and its muscles, which will be chiefly 
 at the time when the fluid is wanted ; and the 
 force with which the jaw must be moved, being 
 as the dryness and hardness of the food masticated, 
 the secretion from the glands depending very much 
 upon that force ; it will also be in proportion to the 
 dryness and hardness of that food which is necessa- 
 ry ; for all food, being to be reduced to a pulp, 
 by being broke and mixed with saliva, before it 
 can be swallowed fit for digestion, the drier and 
 harder foods needing more of this matter, will from 
 this mechanism be supplied with more than moist- 
 er foods in about that proportion in which they 
 are drier and harder ; and the drier foods needing 
 more saliva than moister, is the reason why we 
 can eat less, and digest less of these than those. 
 What quantity of saliva these glands can separate 
 
 u 
 
146 
 
 SALIVARY GLANDS. 
 
 from the blood, in a given time, will be hard to de- 
 termine, but in eating of dry bread it cannot be less 
 than the weight of the bread ; and many men, 
 in a little time, can eat more dry bread than twice 
 the size of all these glands ; and some, that are not 
 used to smoking, can spit half a pint in the smok- 
 ing one pipe of tobacco ; and some men in a sali- 
 vation, have spit, for days or weeks together, a 
 gallon in four and twenty hours ; and yet, I be- 
 lieve, all these glands put together, do not weigh 
 more than four ounces. 
 
 The membrane which lines the mouth and pal- 
 ate, and covers the tongue, is every where beset 
 with small glands, to afford saliva in all parts of 
 the mouth to keep it moist ; for those more remote 
 are chiefly concerned in time of mastication. These 
 small glands have names given them according to 
 their respective situations, as buccales, labiales, 
 linguales, fauciales, palatinse, gingivarum, and. 
 uvulares. 
 
 A gland is chiefly composed of a convolution 
 of one or more arteries of a considerable length, 
 from whose sides arise a vast number of excretory 
 ducts, as the lacteals arise from the guts, to receive 
 in each gland their proper juices, as the lacteals do 
 the chyle ; and though the larger secretions are made 
 by visible glands, yet unconvolved arteries may also 
 have excretory ducts for the same purpose. And 
 this way, I imagine, secretions are made from all 
 the membranes that line cavities, and some others. 
 
SALIVARY GLANDS. 
 
 147 
 
 There also arise from these arteries lymphatic ves- 
 sels, whose use seems to be to take off the thinnest 
 part of the blood, where a thick fluid is to be se- 
 creted, seeing they are found in greatest plenty in 
 such glands as separate the thickest fluids, as in 
 the testicles and liver ; and it is observable that, 
 where the thickest secretions are made, the velocity 
 of the blood is the least, as if it was contrived to 
 give those seemingly more tenacious parts more 
 time to separate from the blood. The arteries that 
 compose different glands are convolved in different 
 manners ; but whether or no their different secre- 
 tions depend at all upon that, I doubt will be dif- 
 ficult to discover. The excretory ducts arise from 
 the arteries, and unite in their progress, as the roots 
 of trees do from the earth ; and as different trees, 
 plants, fruits, and even different minerals, in their 
 growing, often derive their distinct} proper, nu- 
 tritious juices from the same kind of earth ; so the 
 excretory ducts, in different glands, separate from 
 the same mass of blood their different juices : but 
 what these different secretions depend upon, wheth- 
 er the structure of the parts, or different attrac- 
 tions, or what else, we have no certainty about, 
 though this subject has employed several ingenious 
 writers. For my own part, from the great simplic- 
 ity and uniformity usually seen in nature’s works, 
 I am most inclined to think different secretions 
 arise from different attractions, seeing that in plants 
 and minerals there seems to be no other way. 
 
148 
 
 PERITONAEUM, 
 
 CHAPTER IV. 
 
 OF THE PERITONAEUM, OMENTUM, DUCTUS ALI- 
 MENT ALIS, AND MESENTERY. 
 
 PERITONAEUM is a membrane which lines 
 the whole cavity of the abdomen. It contains 
 the liver, spleen, omentum, stomach, guts, and 
 mesentery, with all their vessels and glands ; the 
 upper part of it is no other than the proper mem- 
 brane of the diaphragm, for there is no more rea- 
 son to call that, part of the peritonaeum, than there 
 is for calling the membrane on the other side of 
 the diaphragm, part of the pleura or mediastinum. 
 The fore part next the muscles of the abdomen, 
 and their tendons, may be divided into two lami- 
 nae, yet, I think, anatomists in describing the du- 
 plicature or laminae of the peritonaeum have not 
 always meant this division, but have taken the ten- 
 dons of the transverse muscles for the outer lamina, 
 and considered the other as one membrane, seeing 
 that it is between these tendons and the peritonaeum 
 that the water is found in that kind of dropsy which 
 is called the dropsy in the dupiicature of the peri- 
 tonaeum. Upon the loins the inner surface only is 
 smooth, and the outer part a sort of loose membra- 
 na adiposa, in which are contained the aorta, ve- 
 na cava, vasa spermatica, and pancreas, with oth- 
 er parts of less note. The middle of the perito- 
 naeum upon the loins is joined to the mesentery 
 
OMENTUM, StC. 
 
 149 
 
 in such a manner, as makes some account it a pro- 
 duction of the peritonaeum, and some part of the 
 external membrane of the duodenum, becoming 
 one membrane with the inner or smooth lamina of 
 the peritonaeum, and part of the rectum is covered 
 in the same manner ; but the kidneys and bladder 
 of urine are contained in a distinct duplica'cure of 
 this membrane. The dropsy of the peritonaeum 
 may be distinguished by being least prominent 
 about the navel, for there the tendons and the 
 peritonaeum will not separate ; and the water in 
 those that I have dissected, had made the parts 
 where it was contained as foul as any ulcer ; 
 therefore none of them, I presume, could have 
 been cured by operation. 
 
 For the umbilical vessels, see chap. Of the foe- 
 tus. For the processus vaginalis, chap. Of the 
 parts of generation in men. 
 
 Omentum, or caul, is a fine membrane, larded 
 with fat, somewhat like net-work. It is situ- 
 ated on the surface of the small guts, and resem- 
 bles an apron tucked up ; its outer or upper part, 
 named ala superior, is connected to the bottom 
 of the stomach, the spleen, and part of the in- 
 testinum duodenum ; and thence descending a lit- 
 tle lower than the navel, is reflected and tied to 
 the intestinum colon, the spleen, and part of the duo- 
 denum ; this last part is called ala inferior ; and the 
 space between the ake is named bursa. This cavi- 
 ty is very distinct in most brutes, but seldom so in 
 
150 
 
 DUCTUS ALIMENTALIS. 
 
 men. Sometimes both alae are tied to the liver, 
 and, in diseased bodies, to the peritonaeum. Its use 
 is to lubricate the guts, that they may the better 
 perform their peristaltic motion. Malpighi de- 
 scribes adipose ducts in this membrane to carry the 
 fat from the cells into the vena portae, and thinks 
 it a necessary ingredient in the bile. In dropsies of 
 the abdomen, and in persons who from any other 
 cause have died tabid, it is generally rotten and de- 
 cayed ; and sometimes the guts in these cases adhere 
 to one another : but whether these adhesions pro- 
 ceed from the omentum’s ceasing to perform its of- 
 fice, or from the peristaltic motion of the guts being 
 long discontinued through abstinence, or both, I 
 cannot determine. 
 
 Ductus alimentalis, is the oesophagus, stom- 
 ach, and guts, viz. duodenum, jejunum, ilium, 
 colon, caecum or appendicula vermiformis, and 
 rectum. 
 
 (Esophagus, or gullet, is the beginning of the 
 alimentary duct ; its upper part is wide and open, 
 spread behind the tongue to receive the masticated 
 aliment ; it begins from the basis of the scull, near 
 the processus pterygoides of the sphenoidal bone, 
 then descending: becomes round, and is called va- 
 ginalis gulae ; it runs from the tongue close to the 
 spine, under the left subclavian blood vessels, into and 
 through the thorax on the left side, then piercing 
 the diaphragm, it immediately enters the stomach. 
 It is composed of a thin outer coat, which is no 
 
DUCTUS ALIMENT A LIS. 
 
 151 
 
 more than a proper membrane to the middle or 
 muscular coat. The middle coat is composed of 
 longitudinal and circular muscular fibres, but chiefly 
 circular, abundantly thicker than the same coat 
 in the guts ; because this has no foreign power to 
 assist it, as the guts have, and because it is neces- 
 sary the food should make a shorter stay here than 
 there. The inner coat is a pretty smooth mem- 
 brane, beset with many glands, which secrete a 
 mucilaginous matter, to defend this membrane, 
 and render the descent of the aliment easy. 
 
 Ventriculus, the stomach, is situated under the 
 left side of the diaphragm, its left side touch- 
 ing the spleen, and its right is covered by the thin 
 edge of the liver ; its figure nearly resembles the 
 pouch of a bagpipe, its left end being most capa- 
 cious, the upper side concave, and the lower con- 
 vex : it has two orifices, both on its upper part ; 
 the left, through which the aliment passes into the 
 stomach, is named cardia ; and the right, through 
 which it is conveyed out of the stomach into the 
 duodenum, is named pylorus ; where there is a cir- 
 cular valve which hinders a return of aliment out 
 of the gut, but does not at all times hinder the gall 
 from flowing into the stomach. 
 
 The coats of the stomach are three ; the exter- 
 nal membranous, the middle muscular, whose fi- 
 bres are chiefly longitudinal and circular, the in- 
 ner membranous, and beset with glands, which 
 separate a mucus. This last coat is again divided 
 
152 
 
 DUCTUS ALIMENTALIS. 
 
 by anatomists into a fourth, which they call vrllofa. 
 As the muscular coat of the stomach contracts, the 
 inner coat falls into folds, which increase as the sto- 
 mach lessens, and consequently retard the aliment 
 most when the stomach is nearest being empty. 
 
 The manner in which digestion is performed 
 has been matter of great controversy. The ancients 
 generally supposed the food concocted by a fermen- 
 tation in the stomach ; but the moderns more gen- 
 erally attribute it to the muscular force of the sto- 
 mach ; which Dr. Pitcairne has computed to 
 be equal to a hundred and seventeen thousand and 
 eighty eight pounds weight ; to which being added 
 the absolute force of the diaphragm and abdominal 
 muscles (but for what reason I am at a loss to con- 
 ceive, when so small a part of that force can be ex- 
 erted this way) the sum then will be more than 
 twice as much ; a force indeed equal to the end for 
 which he assigns it. Now this force of the muscu- 
 lar coat of the stomach is near forty times greater 
 than what Borelli has assigned to the heart, 
 which is much stronger ; and Dr. Keil has under- 
 taken to prove, that the force which the heart exerts 
 is not thrice as many ounces as Borelli computes 
 it to be thousand pounds weight. Yet this is as 
 certain, as that action and reaction are the same ; 
 that the abdominal muscles and the diaphragm 
 compress the stomach with no greater force than 
 they do the liver and all other parts contained in the 
 abdomen ; and that the foetus in utero, and all the 
 
DUCTUS A LI MENTAL IS. 
 
 153 
 
 viscera in the abdomen, receive much more of this 
 force, during the time of gestation ; and yet nei- 
 ther the foetus, nor any other contained part, is di- 
 gested by that force ; and for the force with which 
 the stomach itself acts, it will be just the same with 
 the reaction of the food upon it, and therefore 
 should be as much more liable to be digested by 
 this and the other force, than the food, as it oftener 
 feels these forces than that (only that living bodies 
 are not so liable to digestion as dead ones :) besides, 
 it may be demonstrated, that the force with which 
 the stomach compresses any part of its contents, is 
 not greater than what is given to equal parts of the 
 contents in the small guts ; for if the moment of a 
 muscle is as its weight, and if the muscular coat of 
 the stomach does not bear a greater proportion to 
 the muscular coat of a small gut, than their diame- 
 ters bear ; a section of the stomach having so many 
 more equal parts to press than a like section of a 
 gut, it will require just so much more force to give 
 each part the same pressure. Dr. Drake has sup- 
 posed, that digestion is performed in the stomach, 
 as in Papin’s Digester ; in which hypothesis are 
 contained all the absurdities of that of Pitcairne, 
 with this addition, that the stomach must be as ir- 
 resistible to distention at that time, as his iron pot, 
 and the orifices as forcibly secured ; but then in- 
 deed it shews how bits of bones, which dogs swal- 
 low, may be retained in the stomach without tear- 
 ing it ; which difficulty, in my opinion. Dr. Pir- 
 
 w 
 
154 
 
 DUCTUS ALIMENTALIS. 
 
 cairne has not sufficiently accounted for, though 
 it is none of the least in his hypothesis. In gra- 
 nivorous birds, where digestion is made by muscu- 
 lar force, their second stomach is plainly contrived 
 for comminuting or digesting their food that way ; 
 for besides that it is one of the strongest muscles in 
 their bodies, its inside is defended with a hard and 
 strong membrane that it may not be torn j and 
 these birds always eat with their grain the roughest 
 and hardest little stones they can find, which are 
 necessary for grinding their food, notwithstanding 
 it is first soaked in another stomach, and is also 
 food of very easy digestion.. In serpents, some birds, 
 and several kinds of fish, which swallow whole 
 animals, and retain them long in their stomachs, 
 digestion seems to be performed by a menstruum •, 
 for we frequently find in their stomachs animals so 
 totally digested, before their form is destroyed, that 
 their very bones are made soft. In horses and oxen, 
 digestion is but little more than extracting a tinc- 
 ture ; for in their excrements, when voided, we see 
 the texture of their food is not totally destroyed, 
 though grass, in particular, seems to be as easily di- 
 vided as any food whatever, and the corn they eat is 
 often voided entire : and in the excrements of men, 
 are often seen the skins of fruits undigested, and 
 small fruits, such as currants, unbroke, and worms 
 also continue unhurt, both in the stomach and guts. 
 Therefore, by comparing our stomachs with those 
 here mentioned, it appears to me, that our digestion 
 
DUCTUS ALIM ENT AXIS. 
 
 155 
 
 is performed by a menstruum, which is chiefly 
 saliva, gently assisted by the action of the stomach, 
 and the abdominal muscles, and by that principle 
 of corruption which is in all dead bodies. For di- 
 gestion is no other than corruption or putrefaction 
 of our food ; therefore meats preserved from cor- 
 ruption by salt or spirits, are hard of digestion and 
 unwholesome. Nevertheless, when this digesting 
 menstruum of the stomach is too crude, the same 
 salts or spirits, moderately used, become a remedy ; 
 and though meat long salted is so very unwhole- 
 some, it seems not to be from the salt itself, but 
 the meat made undigestible by being long salted:; 
 for those who eat the greatest quantity of salt at 
 their meals are not subjected thereby to the same 
 distempers. And this digesting menstruum, when 
 the stomach is empty, exciting that uneasiness 
 which we call hunger, our appetites and our di- 
 gestion are thereby necessarily suited both as to 
 time and quantity. 
 
 Duodenum is the first of the three small guts ; 
 it begins from the pylorus of the stomach, and is 
 thence reflected downward ; it first passes by the 
 gall bladder, and then under the following gut and 
 mesentery, and coming in sight again in the left 
 hypochondrium, it there commences jejunum, 
 which is the second of the small guts ; but the 
 place where this ends and the other begins is not 
 precisely determined. 
 
156 
 
 BUCTUS A LI MENTAL IS.' 
 
 Jejunum is so called from its being found, for 
 the most part, empty ; it is situated in the regio 
 umbilicalis, and makes somewhat more than a 
 third part of the small guts. It is distinguished 
 from the following gut by its coats, which are a 
 small matter thinner and less pale. 
 
 Ileum is the continuation of the former, situa- 
 ted in the hypogastrium, and very often some 
 part of it in the pelvis of the abdomen, upon the 
 bladder of urine, especially in women ; it enters 
 the colon on the right side, near the upper edge 
 of the os ilium. This great length of the small 
 guts is evidently for the convenience of a greater 
 number of lacteals, that the chyle which misses 
 their orifices in one place may not escape them in 
 another ; but those animals which swallow their 
 food whole, and have it a Ion g time in their stom- 
 ach and salts, have shorter s;uts and fewer lacteals. 
 
 O J O 
 
 Colon is the first of the great guts ; it begins at 
 the upper edge of the right os ilium ; thence 
 ascending passes under some part of the liver, and 
 the bottom of the stomach, from the right hypo- 
 chondrium to the left, and thence descends to the 
 pelvis of the abdomen. 
 
 Caecum, or append! cula vermiformis, is situ- 
 ated on the beginning of the colon : it is less than 
 an earth worm, with a small orifice opening in- 
 to the colon $ this gut has seldom any thing in 
 it. In men it is called one of the large guts, 
 though it is the smallest by far ; but the mistake 
 
BUCTUS ALIMENT AL IS. 
 
 157 
 
 arises from copying the ancients, whose descriptions 
 of all the parts contained in the abdomen, seem to 
 be taken from dogs ; for in them, and in many other 
 animals, it is very large : and some fish have them 
 in great numbers, but very small ; I have counted 
 in a mackerel above one hundred and fifty. 
 
 Rectum is the continuation of the colon through 
 the pelvis to the anus. The lower end of this gut 
 is the seat of the true fistula in ano, which usually 
 runs betwixt the muscular coat and the inner coat ; 
 it is cured by opening it the whole length into 
 the cavity of the gut ; it is yet better, if it can be 
 done, to extirpate all that is fistulous and scirrhous, 
 for that is a sure way to make one operation perfect 
 the cure. The other kind of fistula, improperly so 
 called, is an abscess running round the outside of 
 the sphincter, in the shape of a horse-shoe, being a 
 circle all but where this muscle unites with those 
 of the penis ; this is best cured by opening and re- 
 moving part of the outer skin. The first of these 
 cases happens oftenest in full habits, proceeding fre- 
 quently from the piles ; the last is generally a criti- 
 cal discharge, and one of nature’s last efforts in com 
 ■sumptive and scorbutic habits of body. The inver- 
 sion and sliding down of this gut is called prolapsus 
 ani, a disease common in children, especially those 
 who are afflicted with the stone, and of not much 
 consequence ; in men it is more rare and more 
 dangerous, being generally attended with a flux of 
 humours. This case I have cured by taking away a 
 
158 
 
 DUCTUS ALIM ENT A LIS. 
 
 piece of the prolapsed gut with a caustic, length- 
 ways of the gut ; the wound discharged the flux of 
 humours, upon which the gut was easily reduced, 
 and cicatrising in that state, it never more fell down. 
 
 I have seen a case, where a bold unthinking 
 surgeon having cut off the prolapsed part, the ci- 
 catrix was so hard and contracted that the patient 
 could never after go to stool without a clyster, and 
 then not without great misery. 
 
 Oftentimes the piles occasion large tumours at 
 the lower end of this gut ; these are always best 
 extirpated by ligature ; for if they arc cut, they 
 will sometimes bleed excessively, and it is no easy 
 matter to apply any thing to stop a flux of blood 
 in that part. 
 
 The guts have the same coats with the stomach j 
 the fibres of their middle or muscular coat are cir- 
 cular, or spiral, and longitudinal ; of the latter but 
 very few. The antagonists to these muscular fibres 
 of the stomach and guts, are their contents pressed 
 from one place to another, and the muscles of the 
 abdomen, for these pressing upon them alter their 
 form into one less capacious ; which necessarily 
 extends their circular fibres. The great guts have 
 three membranes, or ligaments, on the outside, run- 
 ning their whole length, and supporting the sacculi, 
 into which those guts are divided. The lesser guts 
 have, at very small distances, semilunar valves placed 
 opposite to the interstices of each other, to prevent 
 the aliment from passing too speedily through the 
 
DUCTUS ALIMENTALIS. 
 
 159 
 
 guts ; and the better to answer that end, they are 
 larger and more numerous near the stomach, where 
 the food is thinner, than they are towards the colon, 
 where the food is continually made thicker in its 
 progress, by a discharge of part of the chyle. This 
 contrivance, so necessary to men, because of their 
 erect posture, when they are obliged, by sickness 
 or accidents, to lie along, becomes a great inconve- 
 nience, and calls for the help of clysters and purges. 
 But brutes have not these valves, because they are 
 not convenient in an horizontal posture. At the 
 entrance of the ileum into the colon, are two very 
 large valves, which effectually hinder the regress of 
 the foeces into the ileum. But clysters have been 
 frequently known to pass them, and be vomited 
 up ; though the excrement that is sometimes vomit- 
 
 I ed up, I am inclined to think, is such as had not 
 passed into the great guts. The other valves in the 
 colon are placed opposite, but not in the same 
 plane, to each other, and make, with their ante- 
 
 [ rior edges, an equilateral triangle ; but as the gut 
 approaches the anus, they become less remarkable, 
 and fewer in number. 
 
 All the guts have in their inner membrane an 
 almost infinite number of very small glands : these 
 glands will, especially some of them in the large 
 guts, appear to the naked eye when they are dis- 
 eased : they are called glandulse pyeriance. 
 
 The length of the guts to that of the body is 
 as five to one in a middle sized man ; in taller men 
 
160 
 
 MESENTERY. 
 
 the proportion is usually less, and in short men 
 greater. 
 
 Mesentery is a membrane beginning loosely up- 
 on the loins, and is thence produced to all the guts : 
 it preserves the jejunum and ileum from twisting 
 in their peristaltic or vermicular motion, and con- 
 fines the rest to their places. It sustains all the 
 vessels going to and from the guts, viz. arteries, 
 veins, lymphxducts, lacteals and nerves, and also 
 contains many glands, called, from their situation, 
 mescntericx. The beginning of this membrane' 
 from the loins, is about three or four inches broad, 
 but next the guts of the same length with the side 
 of the guts they adhere to, which is in the small guts, 
 about a fourth part shorter than the other side ; but 
 when this membrane is separated from the small 
 guts, it shrinks, and measures about two thirds less. 
 
 I opened a boy, about twelve years old, that di- 
 ed of the iliac passion, vulgarly called the twisting 
 of the guts ; the guts, stomach, duodenum, and 
 jejunum were distended, with vapour and air, to 
 near ten times their natural capacity, which so com- 
 pressed the intestinum ileum, that nothing could 
 pass through it. The relations of this boy could 
 give no other account of the cause of this disease, 
 than that of his having eaten a large quantity of 
 raw your.g carrots. This case happens very fre- 
 quently to lambs that have been housed, and turned 
 out early in the spring to grass, when the grass is 
 very rank and succulent ; and also to horses, oxen. 
 
LIVER. 
 
 161 
 
 and sheep, when they happen to feed, by any ao 
 cident, upon young beans or peas, or rich clover 
 grass, which are very apt to ferment in their stom- 
 achs. In these animals this case is commonly cur- 
 ed by running a knife into their guts ; some in- 
 stances of which I have seen, and have heard a 
 great many reported ; but this case happening very 
 rarely to men, I believe that practice has never yet 
 been used ; though the instrument which is used 
 for tapping in a dropsy of the abdomen, might do 
 it with great ease and safety. Some anatomists, 
 who have considered the impossibility of a twisting 
 of the guts, which is the vulgar name of this dis- 
 ease, have imagined that it proceeded from one 
 gut being involved in another. These involutions 
 are found frequently in bodies that die a natural 
 death, and without any inflammation, or any other 
 symptom of pain. 
 
 CHAPTER V. 
 
 Of the liver, gall-bladder, pancreas an© 
 
 SPLEEN. 
 
 The liver is the largest gland in the body • of a 
 dusky red colour. It is situated immediately un- 
 der the diaphragm in the right hypochondrium ; 
 its exterior side is convex, and interior concave ; 
 backward toward the ribs it is thick, and thin 
 on its fore part, where it covers the upper side 
 
 x 
 
162 
 
 LIVER/ 
 
 of the stomach, and some of the guts ; the upper 
 side of it adheres to the diaphragm, and is also tied 
 to it and the sternum by a thin ligament, which is 
 described commonly as two ; the upper part called 
 suspensorium, and the anterior latum : but either 
 of these names is sufficient for it all. It is also tied 
 to the navel by a round ligament called teres or 
 umbilicale, which is the umbilical vein degenerated 
 into a ligament ; it is inserted into the liver at a 
 small fissure in its lower edge. The ligamentum 
 latum, or suspensorium, sustains the liver in an 
 erect posture, or rather fixes it in its situation, while 
 it is supported by the other viscera, they being com- 
 pressed by the abdominal muscles ; in lying down 
 the teres prevents it from pressing on the dia- 
 phragm ; and in lying on the back, they both to- 
 gether suspend it, that it may not compress and ob- 
 struct the ascending vena cava. It is nourished by 
 the branches of the celiac and mesenteric arteries in 
 the liver, called arterix hepaticx, but its blood ves- 
 sels, that compose it as a gland, are the branches of 
 the vena portae, which enters the liver, and distrib- 
 utes its blood like an artery, to have the bile secreted 
 from it j and the branches of the cava in the liver, 
 which return the redundant blood into the cava as- 
 cendens : it has also several branches of nerves, and 
 a great number of lymphatics ; of which I shall treat 
 in their respective places. Dogs and cats, and other 
 animals, that have a great deal of motion in their 
 backs, have their livers divided into many distinct 
 
©ALL-BLADDER. 
 
 163 
 
 iobules ; which, by moving one against another, 
 comply with those motions, which else would break 
 their livers to pieces. 
 
 The gall-bladder is a receptacle of bile, seated 
 in the hollow side of the liver ; it is composed of 
 one dense coat somewhat muscular, which is cov- 
 ered with a membrane like that of the liver ; and 
 is also lined with another, that cannot easily be sep- 
 
 I arated. Modern anatomists have described a num- 
 ber of small ducts leading from the liver to the gall- 
 bladder, by which they suppose the gall-bladder is 
 
 filled : and these I thought I had seen in a human 
 
 . ° 
 
 body that died of a jaundice, when I was a very 
 young anatomist ; but never being able to see any 
 since in any animal, though I have made very dili- 
 gent inquiry by experiments and dissection, I am 
 now persuaded that there are no such ducts ; for if 
 they are too little to be seen or filled by injections, 
 I think they are too little for the end for which 
 they are assigned. As to the argument for the ex- 
 istence of such ducts, which is fetched from the 
 difficulty of the gall-bladder’s being filled through 
 the ductus cysticus from the ductus hepaticus, I 
 think it is of little weight, seeing the vesicuke semi- 
 nales are filled with a thicker fluid through a less di- 
 rect passage. From the gall-bladder towards the du- 
 odenum runs a duct called cysticus ; and from the 
 liver to this duct one called hepaticus, which car- 
 ries off the gall this way, when the gall-bladder 
 is full ; then the ductus cysticus and hepaticus 
 
164 
 
 GALL-BLADDER. 
 
 being united, commence ductus communis chole- 
 dochus, which enters the duodenum obliquely 
 about four inches below its beginning. The ori- 
 fice of this duct in the gut is somewhat eminent, 
 but has no caruncle, as is commonly said. As 
 the liver from its situation in the same cavity with 
 the stomach, will be most pressed, and consequent- 
 ly separate most gall when the stomach is fullest, 
 which is the time when it is most wanted ; so the 
 gall-bladder, being seated against the duodenum, 
 it will have its fluid pressed out by the aliment 
 passing through that gut, and consequently at a 
 right time and in due proportion ; because the 
 greater that quantity of aliment is, the greater will 
 be the compression ; and so the contrary. 
 
 I know no way of computing, with any exact- 
 ness, the quantity of bile that is usually secreted by 
 the liver in a given time ; but if it is four times as 
 much as all the salivary glands secrete, it may be 
 twenty four ounces for every meal : to which be- 
 ing added six ounces of saliva, which, from what 
 is observed in the chapter of the salivary glands, I 
 think will appear a moderate computation : and 
 supposing the pancreas in the same time secretes 
 three ounces, there will then be thirty three 
 ounces of fluids separated for the digestion of one 
 meal ; and that these necessary fluids may not be 
 wasted in such quantities, they pass into the blood 
 with the chyle, and may be soon separated again for 
 the same use ; and very likely, some of the same bile 
 
PANCREAS. 
 
 165 
 
 may be employed more than once, for digesting part 
 of the same meal ; and as the liver exceeds all the 
 glands in the body in magnitude, and its excreto- 
 ry ducts ending in the duodenum, it seems to me 
 to be much more capable of making those large 
 separations from the blood, which are procured by 
 cathartics, than the scarce visible glands of the guts. 
 The liver ordinarily weighs, in a middle sized man, 
 about three pounds twelve ounces, the pancreas 
 three ounces, and the spleen fourteen ounces. I 
 have seen a diseased liver in a man that weighed 
 fourteen pounds four ounces : and in a boy but nine 
 years old, that died hydropic, the liver full of hy- 
 datids, and cysts of hydatids adhering to it, which 
 together weighed seven pounds one ounce and a 
 half, though several pints of water had been let out 
 of it before. The spleen in the same boy, together 
 with the hydatids contained in its membrane, 
 weighed three pounds. In a man I found a diseased 
 spleen, weighing five pounds two ounces ; and in 
 an old man, six feet high, I found a sound liver 
 weighing no more than twenty eight ounces, and 
 the spleen but ten ounces : and in a man that had 
 been cured of a dropsy I found a polypus very solid, 
 almost filling the large branches of the porta in the 
 liver, and a stone between the liver and gall-blad- 
 der, larger than a nutmeg. 
 
 Pancreas, the sweet bread, is a large gland 
 of the salivary kind, lying across the upper and 
 back part of the abdomen, near the duodenum ; it 
 
166 
 
 PANCREAS. 
 
 has a short excretory duct, about half as large as a 
 crow quill, though it is commonly painted as large 
 as the ductus communis choledochus : it always en- 
 ters the duodenum together with the bile duct ; but 
 in dogs some distance from it ; and, I think, al- 
 ways in two ducts distant from one another. The 
 juice of this gland, together with the bile, helps to 
 complete the digestion of the aliment, and renders 
 it fit to enter the lacteal vessels. In a man that died 
 of a jaundice, I found the ductus communis chole- 
 dochus constricted by a scirrhous pancreas, the 
 gall-bladder extended to the size of a goose egg, 
 and all the ducts to twice their natural bigness. 
 This is the case in which I thought I had so plainly 
 seen the cystihepatic ducts : I once saw the ductus 
 cysticus obstructed, without the gall-bladder be- 
 ing distended, which, l think, furnishes us with 
 a very probable argument against the existence of 
 cystihepatic ducts. In those who die of the jaun- 
 dice, for the most part are found in the gall-bladder 
 and the biliary ducts concretions of bile so light as 
 to swim in water, yet are called gall stones : these 
 cause the jaundice, by obstructing the ducts : many 
 of those who have been cured of this disease, have 
 had great numbers of these stones found in their ex- 
 crements. A patient of mine, who had voided by 
 stool several of these stones, had afterwards two of 
 half an inch diameter, which made their way 
 through the integuments of the abdomen, and was 
 cured without much pain. Oxen, as the same gen- 
 
SPLEEN. 
 
 167 
 
 tleman informed me, who have been long fed upon 
 rymeat, abound with them ; while others, fed with 
 them, and afterwards turned to grass, when killed, 
 are found without them. This gentleman could 
 never eat any herbs. He also informed me of a 
 physician in France, that with great reputation 
 cured the jaundice by giving his patients large 
 quantities of the juice of herbs. 
 
 The spleen is seated in the left hypochondrium, 
 immediately under the diaphragm, and above the 
 kidney, between the stomach and the ribs ; it is 
 supported by the subcontained parts, and fixed to 
 its place by an adhesion to the peritonaeum and dia- 
 phragm ; it is also connected to the omentum, as 
 has been observed. The figure of it is a sort of de- 
 pressed oval, near twice as long as broad, and almost 
 twice as broad as thick. Sometimes it is divided into 
 lobules, but for the most part has only one or two 
 small fissures on its edge, and sometimes none ; in 
 its colour it resembles cast iron. The inner texture, 
 in brutes, is vesicular, like the penis ; in which 
 vesicles are found grumous blood, and small bodies 
 like glands : but Ruysch denies that the human 
 spleen is of the same texture. The spleen I have 
 seen taken out of a dog, without any remarkable 
 inconvenience to him. I have twice, in a human 
 body, seen three spleens, twice two, and once four ; 
 some of these were very small, others nearly equal, 
 but altogether in any of these bodies were not 
 larger than the one which is usually found. 
 
VASA LACTEA. 
 
 168 
 
 CHAPTER VJ. 
 
 OF THE VASA EACTEA. 
 
 Vasa lactea are the venae lactese, receptaculum 
 chyli, and ductus thoracicus. 
 
 Venae lacteae, &c. are a Vast number of very 
 line pellucid tubes, beginning from the small guts, 
 and proceeding thence through the mesentery ; 
 they frequently unite, and form fewer and larger 
 vessels, which first pass through the mesenteric 
 glands, and then into the receptaculum chyli. These 
 vessels, ere they arrive at the mesenteric glands, or 
 in dogs the pancreas asellii, which is these glands 
 collected, are called venae lacteae primi generis ; and 
 thence to their entrance into the receptaculum chy- 
 li, venae lacteae secundi generis. The office of these 
 veins is to receive the fluid part of the digested ali- 
 ment, which is called chyle, and convey it to the 
 receptaculum chyli, that it may be thence carried 
 through the ductus thoracicus into the blood vessels. 
 
 For the following excellent description, thus 
 marked “ , of the receptaculum chyli, and ductus 
 thoracicus, I am obliged to Mr. Monro. 
 
 “ Receptaculum chyli pecqueti, or saccus lac- 
 “ teus van home, is a membranous somewhat 
 u pyriform bag, two thirds of an inch long, 
 “ one third of an inch over in its largest part, 
 “ when collapsed ; situated on the first vertebra 
 st lumbrorum, to the right of the aorta, a little higher 
 
VASA LACTEA. 
 
 169 
 
 « than the arteria emulgens dextra, under the right 
 “ inferior muscle of the diaphragm. It is formed 
 “ by the union of three tubes ; one from under 
 44 the aorta, the second from the interstice of the 
 44 aorta and cava, the third from under the emulgents 
 44 of the right side. The saccus chyliferus at its 
 44 superior part becoming gradually smaller, is con- 
 44 tracted into a slender membranous pipe of about 
 44 a line diameter, well known by the name of 
 44 Ductus thoracicus. This passes betwixt the 
 44 appendices musculoss diaphragmatis, on the 
 “ right of, and somewhat behind the aorta, then 
 “ lodged in the cellular substance under the pleu- 
 44 ra ; it mounts between this artery and vena sine 
 “ pari, or azygos, as far as the fifth vertebra 
 “ thoracis, where it is hid by the azygos, as this 
 “ vein rises forward to join the cava descendens ; 
 “ after which the duct passes obliquely over to the 
 44 left side under the oesophagus, aorta, descendens, 
 44 and great curvature of the aorta, until it reaches 
 44 the left carotid, stretching farther towards the 
 44 left internal jugular, by a circular turn, whose 
 44 coir^ex part is uppermost : at the top of this arch 
 44 it splits into two for one half line, the superior 
 44 branch receiving into it a large lymphatic from 
 44 the cervical glands. This lymphatic appears, by 
 44 blowing and injections, to have two valves ; 
 44 when the two branches are united, the duct con- 
 44 tinues its course to the internal jugular, behind 
 44 which it descends, and immediately at the left 
 
 Y 
 
170 
 
 VASA LACTEA. 
 
 “ side of the insertion of this vein, enters the su= 
 t£ perior and posterior part of the left subclavian, 
 whose internal membrane duplicated forms a se~ 
 4C milunar externally convex valve that covers two 
 “ thirds of the orifice of the duct. Immediately 
 “ below this orifice a cervical vein from the mus- 
 “ culi scaleni enters the subclavian. The thin coat 
 <c and valves, commonly ten or twelve, of this duct, 
 “ are so generally known, I need not mention them. 
 “In my notes I find little variation in the recep- 
 “ taculum, only its different capacities in different 
 “ subjects, and' sometimes more ducts concurring 
 “ in the formation of it. The diameter of the duct 
 “ varies in most bodies, and in the same subject is 
 u uniform, but frequently sudden enlargements or 
 “ sacculi of it are observable. The divisions which 
 “ authors mention of this duct within the thorax 
 “ are very uncertain. In a woman I dissected last 
 “ summer, at the eighth vertebra thoracis, one 
 f ' branch climbed over the aorta, and about the 
 “ fifth vertebra slipped back again under that artery 
 “ to the other branch, which continued in the or- 
 u dinary course. Last winter I found this duct of 
 “ a man discharging itself entirely into the right 
 u subclavian vein. The precise vertebra, where it 
 “ begins to turn towards the left, is also uncertain. 
 “ Frequently it does not split at its superior arch ; 
 “ in which case a large saccus is found near its aper- 
 turc into the subclavian vein. Generally it has 
 but one orifice, though^ I have seen two in one: 
 
VASA LA6TEA. 
 
 271 
 
 « 
 
 ^ body, and three in another; nay, sometimes it 
 £C divides into two under the curvature of the great 
 <c artery ; one goes to the right, another to the left 
 ■“ subclavian ; this however is very rare. The lym- 
 44 phatic, which enters the superior arch, is often 
 64 sent from the thyroid gland.” 
 
 Supposing there ordinarily passes five pounds 
 of chyle in a day through the lacteals, and that 
 four ounces of this only are added to the blood 
 (though it may be any other quantity, for aught I 
 know) and that a man neither decreases or increas- 
 es during this time, then all the separations from 
 the fluids and solids must be just five pounds ; four 
 ounces of which must be those fluids and particles 
 of solids, which are become unprofitable ; and the 
 remaining four pounds twelve ounces will serve as a 
 vehicle to carry the four ounces off : so that we see 
 for what reason more fluids are carried into the 
 blood than are to be retained there, and how the 
 •body is by the same means both nourished and pre- 
 served in health. 
 
172 
 
 PLEURA, MEDIASTINUM 1 , 
 
 O 
 
 CHAPTER VII. 
 
 OF THE PLEURA, MEDIASTINUM, LUNGS, PERICAR- 
 DIUM, AND HEART. 
 
 Pleura is a fine membrane which lines the 
 whole cavity of the thorax, -except on the dia- 
 phragm, which is covered with no other than 
 its own proper membrane. The back part of it 
 is extended over the great vessels, like the perito- 
 naeum ; and in regard this membrane passes partly 
 under these vessels, as the peritonaeum does in the 
 abdomen, they may be said to lie in a duplicature 
 of it ; it serves to make the inside of the thorax 
 smooth and equal. 
 
 Mediastinum divides the thorax lengthways, 
 from the sternum to the pericardium and pleura, 
 which is a very short space, but in many brutes 
 very considerable. It divides into two in men, but 
 in brutes it is single ; it divides the thorax not ex- 
 actly in the middle, but towards the left side, and 
 is so disposed, that the two cavities, into which it 
 divides the thorax, do not end toward this mem- 
 brane in an angle, but a segment of a circle ; it 
 hinders one lobe of the lungs from incommoding 
 the other, as in lying on one side the uppermost 
 might do ; and prevents the disorders of one lobe of 
 the lungs from affecting the other. 
 
 The lungs are composed of two lobes, one seated 
 on each side of the mediastinum ; each of which 
 
AND LUNGS, 
 
 173 
 
 lobes are subdivided into two or three lobules, 
 which are most distinctly divided in such animals 
 as have most motion in their backs, for the same end 
 that the liver is in the same animals. They are each 
 composed of very small cells, which are the ex- 
 tremities of the aspera arteria or bronchos. The 
 figure of these cells is irregular ; yet they are fitted 
 to each other so as to have common sides, and leave 
 no void space. Into these cells the blood vessels dis- 
 charge a large quantity of lymph, or materia per- 
 spirabilis, which at once keeps them from being dri- 
 ed by the air, and makes a large and necessary dis- 
 charge from the blood, as has already been observed 
 upon the subject of perspiration through the skin. 
 Dr. Willis has given a very particular description 
 of the inner texture of the lungs, but it is only im- 
 aginary and false, as he, and they who have copied 
 his cuts and descriptions, could not but have known. 
 If they had ever made the least inquiry into the lungs 
 of any animal ; nor is his account of the lymphat- 
 ics on the surface of the lungs, at all more true 
 than that of their texture. In the membranes 
 of these cells are distributed the branches of the 
 pulmonary artery and vein. The known uses of 
 the air’s entering the lungs, are to be instrumental 
 in speech, and to convey effluvia into the nose, as 
 it. passes for the sense of smelling ; but the great 
 use of it, by which life is preserved, I think we 
 do not understand. By some the force of the air is 
 thought to separate the globuli of the blood that 
 
•174 
 
 •LUNGS. 
 
 have cohered in the slow circulation through the 
 veins ; and this opinion seems to be favoured by 
 the many instances of polypuses, which are large 
 concretions of the globuli of the blood, found in 
 the veins near the heart, and in the right auricle 
 and ventricle of the heart ; and their being so seldom 
 found in the pulmonary veins, or in the left auricle 
 or ventricle of the heart, or in any of the arteries j 
 but if it is true that, while the blood passes through 
 the lungs, many cohering globuli are separated, yet 
 it remains to be proved that these separations are 
 made by the force of the air. Dr. Keil has com- 
 puted the force of the air in the strongest exspira- 
 tions against the sides of all the vesicles, to be equal 
 to fifty thousand pound weight j which though w r e 
 should grant, we shall still find the moment of the 
 air in the lungs exceeding small in any small space. 
 For the velocity with which the air moves in the 
 lungs is as much less than that with which it moves 
 in the windpipe, as the square of a section of the 
 cells in the lungs is greater than the square of a sec- 
 tion of the windpipe ; and therefore if the square 
 of all the extreme blood vessels in the lungs do not 
 bear a greater proportion to the square of the large 
 pulmonary vessels than the square of the cells do 
 to the windpipe, and if the blood in these large ves- 
 sels moves as fast as the air in the windpipe, then the 
 blood moving in the smallest vessels of the lungs 
 with a velocity equal to that of the air in the cells, 
 the blood will have as much more attrition froiyj 
 
LUNGS. 
 
 17 . 
 
 the power that moves it in its own vessels, than the 
 xir can give upon them, as blood is heavier than 
 air. Besides, air pressing equally to all sides, and 
 the globuli of the blood swimming in a fluid ; this : 
 pressure, be it what it will, I think, can be of lit- 
 tle use to make such separations. Indeed it may 
 be objected that the greatest pressure is in exspira- 
 tion, yet that surely cannot be very great, while 
 
 I the air has so free a passage out of them. Others 
 have thought, that the air enters the blood vessels 
 from the cells in the lungs, and mixes with the 
 blood ; but this opinion, however probable, wants 
 sufficient experiments to prove it ; air being found 
 in the blood, as it certainly is, is no proof of its 
 entering this way, because it may enter with the 
 chyle : nor is the impossibility which has been 
 urged of its entering at the lungs without the blood 
 being liable to come out the same way into the ve- 
 : sides of the lungs, a good argument to the contra- 
 ry ; for if a pliable duct passes between the mem- 
 branes of a vessel, through a space greater than 
 the square of its orifice, no fluid can return, because 
 the pressure which should force it back will be 
 greater against the sides of that duct than its orifice ; 
 which is the case of the bile-duct entering the duo- 
 denum, arid the ureters entering the bladder. I 
 think the most probable argument for the air’s en- 
 tering into the blood by the lungs, or rather some 
 particular part of the air, may be fetched from a / 
 known experiment of each man in a diving bell 
 
LUxtiS. 
 
 176 
 
 wanting near a gallon of fresh air in a minute ; and 
 if pressure only was wanted in this case, they often 
 .descend, till the pressure of the air is three or four 
 times what it is upon the surface of the earth, with-* 
 out any advantage from that pressure ; and animals 
 dying so soon in air that has been burnt, and their 
 being so easily intoxicated by breathing air much 
 impregnated with spirituous liquors, are also argu- 
 ments of a passage this way into the blood. Besides, 
 if pressure of the air in the cells of the lungs is the 
 only use of it, I do not see but enough of that may 
 be had while a man is hanging, if tno muscles of 
 the thorax do but act upon the air which was 
 left in the thorax when tiie rope was first fixed,, 
 and yet death is brought about by hanging no other 
 way than by interrupting of the breath, as I have 
 found by certain experiments. Dr. Drake has 
 endeavoured to shew, that the use of respiration is 
 to assist the systole of the heart ; but this use re- 
 quires that the systole and diastole of the heart 
 should keep time with exspiration and inspiration, 
 which is contrary to experience. The lungs of an- 
 imals, before they have been dilated with air, are 
 specifically heavier than water ; but upon inflation 
 they become specifically lighter, and swim in wa- 
 ter ; which experiment may be made to discover 
 whether a dead child was still born, or not ; but if 
 the child has breathed but a little, and the experi- 
 ment is made long after, the lungs may be collapsed 
 and grow heavier than water, as I have experiment- 
 
PERICARDIUM AND HEART. 177 
 
 ed, which may sometimes lead a man to give a 
 wrong judgment in a court of judicature, but then 
 it will be on the charitable side of the question. 
 Adhesions of the lungs to the pleura are in men so 
 common, that I know not how to call it a disease 5 
 they being found so more or less in most adult 
 persons, and without any inconvenience, if the 
 lungs are not rotten. 
 
 Pericardium, or heart purse, is an exceeding 
 strong membrane which covers the heart ; its 
 side next the great vessels is partly connected to 
 them, and partly to the basis of the heart, but, 
 I think, not properly perforated by those vessels 5 
 and its lower side is inseparable from the tendinous 
 part of the diaphragm, but not so in brutes, in 
 some of which there is a membranous bag between 
 it and the diaphragm, which contains a lobule of 
 the lungs. It encloses all the heart to its basis ; 
 its uses are to keep the heart in its place, without 
 interrupting its office, to keep it from having any 
 friction with the lungs, and to contain a liquor 
 to lubricate the surface of the heart, and abate its 
 friction against the pericardium. 
 
 The heart is a muscle of a conic figure, with 
 two cavities or ventricles 5 its basis is fixed by the 
 vessels going to and from it, upon the fourth and 
 fifth vertebrae of the thorax ; its apex, or point, 
 is inclined downward and to the left side, where- 
 it is received in a cavity of the left lobe of the 
 lungs, as may be observed, the lungs being extended 
 
178 • - HEART. 
 
 with air. This incumbrance on the left lobe of the 
 lungs, 1 imagine, is the cause of that side’s being 
 most subject to those pains which are usually called 
 pleuritic, which I have ever found upon dissecting 
 of them to be inflammations in the lungs. 
 
 At the basis of the heart, on each side, are situ- 
 ated the two auricles to receive the blood the right 
 from the two venae cavae, and the left from the pul- 
 monary Veins ; in the right, at the meeting of the 
 cavae, is an eminence called tuberculum Loweri* 
 which directs the blood into the auricle ; immedi- 
 ately below this tubercle, in the ending of the cava 
 ascendens, is the vestigium of the foramen ovale 
 (vid. chap. Of the foetus ;) and near this, in the 
 auricle, is the mouth of the coronary veins. Both 
 auricles are strengthened by muscular columnae, like 
 the ventricles. The left is much less than the right ; 
 but the difference is supplied by a large muscular 
 cavity, which the veins from the lungs afford in that 
 place. The sides of this muscular cavity are thicker 
 than the sides of the right auricle, in about that 
 proportion, in which the left ventricle of the heart 
 is stronger than the right j their uses being to re- 
 ceive blood from the veins that lead to the heart, 
 and press it into the ventricles, a strength in each au- 
 ricle proportionable to the strength of the Ventricle 
 that it is to fill with blood, seems necessary : and 
 this different thickness of the coats of the auricles 
 makes the blood in the left, which is thickest, ap- 
 pear through it of a paler red ; but when it is let 
 
HEART. 
 
 179 
 
 out of the auricles, it appears alike from both ; which 
 they would do well to examine, who affirm the 
 blood returns from the lungs of a more florid col- 
 our than it went in ; and offer it as an argument 
 of the blood’s being mixed with air in the lungs. 
 The ventricles or cavities in the heart which receive 
 the blood, are hollow muscles, or two cavities in 
 one muscle, whose fibres intersect one another, so 
 as to make the pressure of the heart upon the blood 
 more equal and effectual, and are also less liable to 
 be separated than they would have been, if they had 
 lain in one direction. Both these cavities receiv- 
 ing the same quantities of blood in the same times, 
 and always acting together, must be equal in size, 
 if they equally discharge what they contain at every 
 systole, as I doubt not but they do ; nevertheless, 
 the left appears less than the right, it being found 
 empty in dead bodies, and the right usually full of 
 blood ; which made the ancients think the veins 
 and the right ventricle only were for the blood to 
 move in, and that the left and the arteries contain- 
 ed only animal spirits. The left ventricle is much 
 the thickest and strongest, its office being to drive 
 the blood through the whole body, while the right 
 propels it through the lungs only. Over the en- 
 trance of the auricles in each ventricle, are placed 
 valves to hinder the return of blood while the heart 
 contracts. Those in the right ventricle are named 
 tricuspides, those in the left mitrales. One of these 
 last seems to do further service, by covering the 
 
180 
 
 HEART. 
 
 mouth of the aorta while the ventricle fills ; which 
 suffering none of the blood to pass out of this ven- 
 tricle into the aorta before the ventricle acts, it will 
 be able to give greater force to the blood than it 
 otherwise might have done ; because a greater quan- 
 tity of blood more fully distending the ventricle, 
 and making the greater resistance, it will be capa- 
 ble of receiving the greater impressed force from 
 the ventricle ; and if the blood is no way hindered 
 in the right ventricle from getting into the pulmo- 
 nary artery, while the ventricle dilates, as it is in the 
 left, the left then may be somewhat bigger than 
 the right, if they both empty themselves alike in 
 every systole. Though the auricles of the heart 
 are equal to each other, and the two ventricles also 
 equal or nearly equal, yet the auricles are not so 
 large as the ventricles ; for the ventricles contain 
 not only ail the blood which flowed from the veins 
 into the auricles, during the contraction of the heart, 
 but also that which flows (which will be directly 
 into the heart) while the auricles contract, and the 
 ventricles dilate ; which leads us to the exact knowl- 
 edge of the use of the auricles. If the systole and 
 diastole of the heart are performed in equal times, 
 then the auricles must be half the size of the ven- 
 tricles ; or whatever proportion the space of time, 
 of the systole of the heart bears to the space in 
 which the systole and diastole arc both performed, 
 that proportion will the cavities of the auricles 
 frear to the cavities of the ventricles. The inne? 
 
HEART. 
 
 181 
 
 fibres of each ventricle are disposed into small cords, 
 which are called columns : from some of these 
 stand small portions of flesh called papillae ; these 
 papillae are tied to the valves by slender fibres, 
 whereby they keep the valves from being pressed 
 into the auricles by the action of the blood against 
 them - in the systole of the heart : and when that 
 is over, the blood flowing in between them opens 
 them, as the pressure of blood on the other side 
 shuts them in the systole. For the course of the 
 blood through this part, vid. chap. Of the course 
 of the aliment and fluids. In the beginning of 
 each artery from the heart are placed three valves, 
 which look forward, and close together to hinder 
 a regress of blood into the ventricles. Those in 
 the pulmonary artery are named sigmoidales, those 
 in the aorta, semilunares. For the canalis arteri- 
 osus, vid. chap. Of the foetus. 
 
 In a boy I found a great quantity of pus in the 
 pericardium, and the basis of the heart ulcerated. 
 In persons that have died of a dropsy, I have usu- 
 ally observed the heart large, its fibres lax, and the 
 vessels about it immoderately distended, and poly- 
 puses sometimes in both auricles and ventricles, 
 and in the large veins ; but more frequently in 
 the right auricle and ventricle. Mr. Pile has 
 prepared a heart thus diseased, whose circumfer- 
 ence from the vertex round the base of the auri- 
 cles measures twenty four inches and a quarter, 
 and round the base of the ventricles seventeen 
 
182 HEART. 
 
 inches and a half. I dissected a man that died 
 tabid, in whom the pericardium universally ad* 
 hered to the heart, and a portion of the muscular 
 part of the heart was ossified as large as a six- 
 pence. The beginning of the aorta is frequently 
 seen ossified, especially in aged persons. In a wom- 
 an that died of a dropsy, I found the valves of the 
 aorta quite covered with chalk stones, which not 
 suffering the valves to do their office, the left 
 ventricle of the heart was constantly overcharged 
 with blood, and distended to above twice its nat* 
 ural bigness, which, I imagine, destroyed the econ- 
 omy of the body, and occasioned the dropsy. 
 
 Upon opening the body of a person, who died 
 with excessive palpitations of the heart and un- 
 even pulse, which began after very hard drinking, 
 in extreme hot weather, some years before, I 
 found about ten inches of the aorta nearest the 
 heart distended three times its natural diameter ; 
 and in a man one hundred and three years old, I 
 found the same part of the aorta extended twice 
 its natural capacity, without any symptom of such 
 a disorder when living. 
 
ARTERIES AND VEINS. 
 
 183 
 
 CHAPTER VIII. 
 
 OF THE ARTERIES AND VEINS. 
 
 F ROM the right ventricle of the heart arises the 
 pulmonary artery, which soon divides into two 
 branches, one to each lobe of the lungs ; then 
 they subdivide into smaller and smaller branches, 
 until they are distributed through every part of the 
 lungs. From the extreme branches of the pulmo- 
 nary artery arise the small branches of the pulmo- 
 nary veins ; which, as they approach the left auri- 
 cle of the heart, unite in such a manner as the pul- 
 monary artery divides going from the heart, only 
 that the veins enter the muscular appendix of the 
 left auricle in several branches, and the blood being 
 brought back from the lungs by these vessels to the 
 left auricle and ventricle of the heart, it is from the 
 left ventricle of the heart thrown into the aorta. 
 
 Aorta, or great artery, arises from the left 
 ventricle of the heart, and deals out branches to ev- 
 ery part of the body. The first part of this vessel 
 is called aorta ascendens : it passes over the left 
 pulmonary artery, and veins, and branch of the as- 
 pera arteria, and being reflected under the left lobe 
 of the lungs, it commences aorta descendens ; which 
 name it keeps through the thorax and abdomen, 
 where it passes on the left side of the spine, till its 
 
184 ARTERIES AND VEINS. 
 
 division into iliac arteries between the third and 
 fourth vertebrae of the loins. 
 
 From under two of the semilunar valves of the 
 aorta, which is ere it leaves the heart, arise two 
 branches (sometimes but one) which are bestowed 
 upon the heart, and are called coronarke cordis* 
 From the curved part of the aorta, which is about 
 two or three inches above the heart, arise the sub- 
 clavian and carotid arteries ; the right subclavian 
 and carotid in one trunk, but the left single. By 
 some authors these vessels have been described in 
 a different manner ; but I believe their descrip- 
 tions were, for want of human bodies, taken from 
 brutes ; for I have never yet seen any variety in 
 these vessels in human bodies, though I have in 
 the veins nearer the heart : and indeed there seems 
 to me to be a mechanical reason for their going off 
 in the manner here described, in human bodies ; 
 for the right subclavian and carotid arteries neces- 
 sarily going off from the aorta at a much larger an- 
 gle than the left, the blood would move more free- 
 ly into the left than the right, if the right did not 
 go off in one trunk, which gives less friction to the 
 blood than two branches equal in capacity to that 
 one ; so that the advantage the left have by going 
 off from the aorta at much acuter angles than the 
 right, is made up to the right by their going off at 
 first in but one branch. - 
 
 The carotid arteries run on both sides the la- 
 rynx to the sixth foramina of the scull, through 
 
ARTERIES AND VEINS. 
 
 185 
 
 which they enter to the brain ; but as they pass 
 through the neck, they detach branches to every 
 part about them, which branches are called by the 
 names of the parts they are bestowed upon ; as, 
 kryngeae, thyroideae, pharyngeae, linguales, tem- 
 porales, occipitales, faciales, &c. but just before they 
 enter the sixth foramina of the scull, they each 
 send a small branch through the fifth foramina to 
 that part of the dura mater which contains the 
 cerebrum. It is these arteries which make 
 those impressions which are constantly observed on 
 the inside of the ossa bregmatis : these branches, 
 Mr. Monro observes, oftener arise from the tempo- 
 ral arteries. The internal carotids send two branch- 
 es to the back part of the nose, and several branches 
 through the first and second foramina of the scull 
 to the face and parts contained within the orbits of 
 the eyes, and then piercing the dura mater, they 
 each divide into two branches, one of which they 
 send under the falx of the dura mater, between the 
 two hemispheres of the brain, and the other be- 
 tween the anterior and posterior lobes. These 
 branches take a great many turns, and divide into 
 very small branches in the pia mater before they en- 
 ter the brain, as if the pulse of larger arteries would 
 make too violent an impression on so tender and 
 delicate a part. And perhaps it may be from an 
 increase of the impulse of the arteries in the brain, 
 which strong liquors produce, that the nerves are 
 so much interrupted in their uses throughout the 
 
 a a 
 
186 
 
 ARTERIES AND VEINS'. 
 
 whole body, when a man is intoxicated with drink*’ 
 ing ; and may it not also be from a like cause that 
 men are delirious in fevers ? Besides these two ar- 
 teries, viz. the carotids, the brain has two more, 
 called cervicales, which arise from the subclavian 
 arteries, and ascend to the head through the fora- 
 mina, in the transverse processes of the cervical 
 vertebrae, and into the scull through the tenth or 
 great foramen. These two arteries uniting soon 
 after their entrance, they give oil branches to the 
 cerebellum, and then passing forward, divide and 
 communicate with the carotids ; and the carotid ar- 
 teries communicating with each other, there is an 
 entire communication between them all ; and these 
 communicant branches are so large that every one 
 of these four great vessels, with all their branches, 
 may be easily filled with wax through any one of 
 them. 
 
 The subclavian arteries are each continued to 
 the cubit in one trunk, which is called axillaris as 
 it passes the arm pits, and humeralis as it passes by 
 the inside of the os humeri, between the muscles 
 that bend and extend the cubit. From the sub- 
 clavians within the breast arise the arteriae mamma- 
 rite, which run on the inside of the sternum, and 
 lower than the cartilago ensiformis. Soon after the 
 arteria humeralis has passed the joint of the cubit, 
 it divides into two branches, called cubitalis superi- 
 or, and cubitalis inferior ; which latter soon sends off 
 a branch, called cubitalis media, which is bestowed. 
 
ARTERIES AND VEINS. 
 
 187 
 
 $ipon the muscles seated about the cubit. The 
 cubitalis superior passes near the radius, and round 
 the root of the thumb, and gives one branch to 
 the back of the hand, and two to the thumb ; one 
 to the first finger and a branch to communicate 
 with the cubitalis inferior. The cubitalis inferior 
 passes near the ulna to the palm of the hand, where 
 it takes a turn, and sends one branch to the outside 
 of the little finger, another between that and the 
 next finger, dividing to both, another in the same 
 manner to the two middle fingers, and another to 
 the two fore fingers. These branches which are 
 bestowed on the fingers run one on each side of 
 each finger internally to the top, where they have 
 small communications, and very often there is a 
 branch of communication between the humeral 
 and inferior cubital arteries. This communicant 
 branch is sometimes very large, and liable to be 
 pricked by careless or injudicious blood letters, in 
 bleeding in the basilic vein, immediately under 
 which, as far as I have been able to observe, this 
 branch always lies. Mr. Monro has found the 
 subclavian artery divided, in one subject, into two, 
 the exterior of which formed the cubitalis superi- 
 or, and the inner artery, the cubitalis inferior ; from 
 which structure he accounts for the success in the 
 operation of the aneurism sometimes performed 
 above the cubit. When the operation for an 
 aneurism is made upon this communicant branch, 
 it is found necessary to tie it on both sides of the 
 
188 
 
 ARTERIES AND VEINS. 
 
 orifice, because the blood is liable to flow freely into 
 it either way. 
 
 From the descending; aorta on each side is sent 
 a branch under every rib, called intercostalis, and 
 about the fourth vertebra of the back it sends off 
 two branches to the lungs, called bronchiales, which 
 are sometimes both given off from the aorta, some- 
 times one of them from the intercostal of the fourth 
 rib on the right side ; and as the aorta passes under 
 the diaphragm, it sends two branches into the dia- 
 phragm, called arterise phrenicae, which some- 
 times rise in one trunk from the aorta, and some- 
 times from the cceliaca ; but oftener the right from 
 the aorta, and the left from the cceliaca. Immedi- 
 ately below the diaphragm arises the coeliac artery 
 from the aorta ; it soon divides into several branch- 
 es, which are bestowed upon the liver, pancreas, 
 spleen, stomach omentum, and duodenum. These 
 branches are named from the parts they are bestow- 
 ed on, except two that are bestowed upon the stem- 
 ach, which are called coronaria superior and infe- 
 rior, and the branch bestowed upon the duodenum, 
 which is named intestinalis. At a very small dis- 
 tance below the arteria cceliaca from the aorta arises 
 the mesenterica superior, whose branches.are bestow- 
 ed upon all the intestinum jejunum and ilium, part of 
 the colon, and sometimes one branch upon the liver. 
 A little lower than the superior mesenteric artery 
 arise the emulgents, which are the arteries of the kid- 
 neys. And a little lower than the emulgents, for- 
 
ARTERIES AND VEINS, 
 
 189 
 
 ward from the aorta, arise the arterix spermaticae ; 
 for which, vid. chap. Of the parts of generation 
 in men. Lower laterally the aorta sends branches 
 to the loins, called lumbales ; and one forward, to 
 the lower part of the colon and the rectum, called 
 mesenterica inferior. Between the arteria cceli- 
 aca, mesenterica superior and inferior, and the 
 branches of each near the guts, there are large 
 communicant branches to convey the blood from 
 one to another, when they are either compressed 
 by excrements, or from any other cause. 
 
 As soon as the aorta divides upon the loins, it 
 sends off an artery into the pelvis upon the os sa- 
 crum, called arteria sacra, and the branches the 
 aorta divides into are called iliacx, which in about 
 two inches space divide into external and internal. 
 The iliacae interns first send off the umbilical ar- 
 teries, which are dried up in adult bodies, except at 
 their beginnings, which are kept open for the col- 
 lateral branches on each side, one to the bladder, 
 and one to the penis in men, and in women the 
 uterus : the rest of these branches are bestowed up- 
 on the buttocks and upper parts of the thighs. 
 The iliacx externx run over the ossa pubis into 
 the thighs ; and as they pass out of the abdomen 
 they send off branches, called epigastricx to the 
 fore part of the integuments of the abdomen un- 
 der the recti muscles. And the epigastric arteries 
 send each a branch into the pelvis, and through the 
 foramina of the ossa innominata to the muscles 
 
190 
 
 ARTERIES AND VEINS. 
 
 thereabouts. As soon as the iliac artery is passed 
 out of the abdomen into the groin it is called in- 
 guinalis, and in the thigh cruralis, where it sends 
 a large branch to the back part of the thigh ; but 
 the great trunk is continued internally between 
 the flexors and extensors of the thigh, and passing 
 through the insertion of the triceps muscle into the 
 ham, it is there called poplitea ; then below the 
 joint it divides into two branches, one of which is 
 called tibialis antica ; it passes between the tibia 
 and fibula to the fore part of the leg, and is be- 
 stowed upon the great toe, and one branch to the 
 next toe to the great one, and another between 
 these toes, to communicate with the tibialis posti- 
 ca ; which artery, soon after it is divided from the 
 antica, sends off the tibialis media, which is bestow- 
 ed upon the muscles of the leg $ the tibialis postica 
 goes to the bottom of the foot and all the lesser 
 toes. The tibialis antica is disposed like the cubita- 
 lis superior ; the postica like the cubitalis inferior ; 
 and the mediae in each have also like uses. These 
 arteries which I have described, are uniform in most 
 bodies, but the lesser branches are distributed like 
 the branches of trees, in so different a manner in 
 one body from another, that it is highly probable 
 no two bodies are exactly alike, nor the two sides 
 in any one body. 
 
 I have once seen a rupture of matter, and once 
 of blood and matter, which flowed out of the ab- 
 domen into the fore part of the thigh, through the 
 
Arteries and veins* 
 
 191 
 
 Same passage at which the iliac artery goes out o£ 
 the abdomen. 
 
 The veins arise from the extremities of the ar- 
 teries, and make up trunks which accompany the 
 arteries in almost every part of the body, and have 
 the same names in the several places which the ar- 
 teries have, which they accompany. The veins of 
 the brain unload themselves into the sinuses (vid. 
 chap. Of the dura and pia mater) and the sinuses 
 into the internal jugulars and cervicals ; and the 
 internal jugulars and cervicals into the subclavians, 
 which joining, make the cava descendens. The 
 internal jugulars are seated by the carotid arteries, 
 and receive the blood from all the parts which the 
 carotids serve, except the hairy scalp and part of 
 the neck, whose veins enter into the external ju- 
 gulars, which run immediately under the musculus 
 quadratus gense, often two on each side. The cer- 
 vical veins descend two through the foramina in the 
 transverse processes of the cervical vertebrae, and two 
 through the great foramen of the spine, and one on 
 each side the spinal marrow ; these join at the low- 
 est vertebra of the neck, and then empty into the 
 subclavians, and at the interstices of all the vertebrae 
 communicate with one another. 
 
 The veins of the limbs are more than double 
 the number of the arteries, there being one on each 
 side each artery, even to the smallest branches that 
 we can trace, besides the veins which lie immedi- 
 ately under the skin. Those which accompany the 
 
192 ARTERIES AND VEINS. 
 
 arteries, have the same names with the arteries ; 
 those which run immediately under the skin on the 
 back of the hand, have no proper names ; they run 
 from thence to the bend of the elbow, where the up- 
 permost is called cephalica, the next mediana, the 
 next basilica. These all communicate near the joint, 
 of the elbow, and then send one branch which is 
 more directly from the cephalica, and bears that 
 name until it enters the subclavian vein ;• it passes 
 immediately under the skin, in most bodies, be- 
 tween the flexors and extensors of the cubit, on the 
 upper side of the arm. The other branches joining, 
 and receiving those which accompany the arteries 
 of the cubit, they pass with them by the artery 
 of the arm into the subclavian vein. The external 
 veins have frequent communications with the in- 
 ternal, and are always fullest when we use the 
 most exercise ; because the blood being expanded 
 by the heat which exercise produces, it requires the 
 vessels to be distended j and the inner vessels being 
 compressed by the actions of the muscles, they 
 cannot dilate enough ; but these vessels being seat- 
 ed on the outsides of the muscles, are capable of 
 being much dilated ; and this seems to me to be the 
 chief use of these external vessels. The cephalic 
 vein, as it runs up the arm, is very visible in most 
 men, but in children is rarely to be seen ; there- 
 fore ureat care should be taken not to wound it in 
 
 O 
 
 the cutting of issues in children’s arms ; and I know- 
 no way to be sure of avoiding it, but by cutting the 
 
ARTEP.IE9 AND VEINS'. 
 
 193 
 
 issue more externally than is usual in men, which 
 may be done without any inconvenience. 
 
 In the thorax, besides the two cavae, there is a 
 vein called azygos, or vena sine pari ; it is made up 
 of the intercostal, phrenic, and bronchial veins, 
 and enters the descending cava near the auricle, 
 as if its use was to divert the descending blood 
 from falling too directly upon the blood in the 
 ascending cava, and direct the blood of the de- 
 scending cava into the auricle. 
 
 In the abdomen (besides the cava ascendens and 
 the veins which are named like the arteries, viz. 
 the emulgents from the kidneys, the lumbal and 
 spermatic veins, the sacra, iliac, and hypogastric 
 veins) there is one large one called vena portae, 
 whose branches arise from all the branches of the 
 cceliac and two mesenteric arteries, except those 
 branches of the coeliac and superior mesenteric, 
 which are bestowed on the liver, and uniting in 
 one trunk enters the liver, and is there again dis- 
 tributed like an artery, and has its blood collected 
 and brought into the cava by the branches of the 
 cava in the liver ; this vein being made use of in- 
 stead of an artery to carry blood to the liver, for 
 the separation of bile. It moves here about eight 
 times slower than in the arteries hereabouts ; and 
 this slow circulation being supposed necessary, I 
 think, there seems no other way so' fit to procure 
 it ; for if an artery had been employed for this use, 
 and been thus much dilated in so short a passage, 
 Bb 
 
Arteries and veins'. 
 
 194 
 
 the blood would not have moved so uniformly in 
 it, but faster through its axis than near its sides ; 
 and besides, it is very probable that the blood in 
 this vein, having been first employed in nourish- 
 ing several parts, and having through a long space 
 moved slowly, may be made thereby fitter for the 
 separation of bile, than blood carried by an artery 
 dilated to procure a circulation of the same velocity 
 with that in this vein. 
 
 In the leg the veins accompany the arteries in 
 the same manner as in the arm, the external veins 
 of the foot being on the upper side, and from them 
 is derived one called saphena, which is continued 
 on the inside of the limb its whole length, and 
 has several names given it from the several places 
 through which it passes. 
 
 The arteries have three coats ; a middle mus- 
 cular, and an external and internal membranous. 
 The veins are said to have the same ; the internal 
 coat of an artery may be pretty easily separated, but 
 not the external ; and though the veins have mus- 
 cular fibres, yet I could never separate any one dis- 
 tinctly into three coats ; and in the inside of the 
 veins there are many valves, especially in the low- 
 er limbs, to hinder any reflux of the venal blood, 
 which otherwise would have happened from the 
 frequent actions of the muscles on the outsides of 
 the' veins ; and both the arteries and veins, as they 
 run in the inside of the limb, or as they are dis- 
 persed in parts that suffer great extensions, as the 
 
Arteries and veins- 
 
 I9S 
 
 stomach, guts, and uterus, they are curved so 
 much as that when these parts come to be distend- 
 ed, they may comply with those distensions by only 
 being straitened, and so preserved from being 
 stretched, which would lessen their diameters. The 
 small arteries near the heart go off from the large 
 trunks at obtuse angles, farther at less obtuse angles., 
 then at right angles, farther still at acute angles, 
 and near the extremities at very acute angles, be- 
 cause die blood in the vessels far from the heart 
 moi ing with less velocity than the blood in the 
 vessels near the heart, the blood in the collateral 
 branches more remote from the heart wants the 
 advantage of a directer course ; and because a very 
 large branch arising out of another, might weaken 
 too much the sides of the vessel it would arise from, 
 that inconvenience is prevented by increasing the 
 number, and so lessening the size of the collateral 
 branches, where otherwise one large branch would 
 have served better ; as in the going off of the sub- 
 clavian and carotid arteries, which might have gone 
 off for some space in one trunk ; but this mechan- 
 ism is more evident in the going off of the arteria 
 coeliaca and mesenterica superior. And the small 
 arteries always divide so as that the lesser branch 
 may lie least in the direction of the blood flowing 
 into diem, which makes the blood flow most freely 
 into that branch that hath farthest to carry it ; and 
 the smaller branches arise more or less obliquely 
 from the sides of other arteries, according to the 
 
196 
 
 ARTERIES AND VEINS. 
 
 proportion they bear to the arteries they arise from, 
 because an artery comparatively large arising ob- 
 liquely from the side of another, would make an 
 orifice in that it arises from too large, and weaken 
 it. And both these ends are at once brought about, 
 by making the arteries, that give off the branches, 
 bend more or less toward the branches they give 
 off, according to the comparative magnitude of the 
 branches given off. 
 
 Borelli has computed the force which the 
 heart exerts at every systole, to be equal to three 
 thousand pounds weight, and the force which all 
 the arteries exert at every systole, to be equal to 
 sixteen thousand pounds weight, and that they to- 
 gether overcome a force equal to an hundred and 
 thirty six thousand pounds weight ; and Dr. Keil 
 has computed that the heart in every systole exerts 
 a force not exceeding eight ounces. The first com- 
 putation was made by comparing the heart with 
 other muscles, whose power to sustain a weight could 
 be best determined ; and the latter was made from 
 the velocity of the blood moving in an artery : 
 therefore if we consider that Borelli’s way of 
 computing led him to find out the absolute force of 
 the heart, and Dr. Kiel’s the force which the heart 
 usually exerts, perhaps these very different compu- 
 tations may be accounted for ; for if the force of 
 the heart, which is constantly exerted, should, com- 
 pared with any other muscle, be but in a reciprocal 
 proportion to the frequency of their actions, and 
 
ARTERIES AND VEINS. 
 
 197 
 
 the importance of their uses ; may not the heart 
 very fitly have a force vastly greater than usually it 
 exerts, because it is always in action, and must be 
 able to exert a certain force in the lowest state of 
 health ? What force the heart ever exerts in a grown 
 man, I cannot say ; but it must be less in each ven- 
 tricle than is sufficient to burst the valves, which 
 hinder the blood from returning into the auricles 
 out of the ventricles, or than is sufficient to break 
 those threads by which these valves are tied to the 
 papillse. In a dog, I found the force which the 
 heart would exert, would not raise to one foot per- 
 pendicular height a column of blood through the 
 aorta ascendens. And when I inject the arteries of 
 a child, I find a force exceeding little will throw 
 water through all the vessels, with a velocity equal 
 to that with which the blood moves in those vessels 
 when living. And if the heart, like other muscles, 
 can perform the first part of its contraction with 
 most ease, are not the quick actions of the heart in 
 hectic fevers owing to its not being able to empty 
 the ventricles every systole, which, I think, will 
 oblige it to act, aeteris paribus, so much the often- 
 er ? For the following ingenious attempt to ac- 
 count for the systole and diastole of the heart, and 
 the reciprocal actions of the auricles and ventricles, 
 I am obliged to Mr. Monro. 
 
 c< Postulata, that the action of the muscles de- 
 <(C pends on the influx of blood and liquidum ner- 
 ^ vosum into the muscular fibres, and therefore, 
 
198 
 
 ARTERIES AND VEINS. 
 
 p4 whenever the muscles are deprived of either or 
 44 both these fluids, their action ceases ; this a great 
 44 many authors have fully proved by tying and 
 4:4 cutting the nerves and arteries that serve any 
 44 muscle. That all muscles are in a constant state 
 44 of contraction as long as the blood and liquidum 
 4C nervosum are freely supplied to them, which 
 44 seems evident from the sphincter ani and vesiae, 
 44 and from the continued contraction of such mus- 
 44 cles, whose antagonists are cut asunder, .or pa- 
 44 ralytic. That the nerves of the heart run to it 
 “ between the auricles and arteries, and that the 
 44 arteriae coronarke rise from the aorta behind the 
 • t4 valvulce semiiunares, both which are evident from 
 44 dissections. If then both auricles and ventricles 
 44 are ready, upon the first communication of mo- 
 44 tion, to contract at the same time, the ventricles, 
 44 as Dr. Keil well observes, being stronger, will 
 44 first contract, and hinder the contraction of the 
 44 auricles, which must be in the mean time much 
 44 dilated by the influx of blood from the veins, 
 44 while the arteries are also distended by the blood 
 44 thrown out of the ventricles ; therefore the car- 
 j4c diac nerves lying between the two will be com- 
 44 pressed; and the coui'se of the liquids in them stop- 
 44 ped ; at the same time the blood that rushes out 
 f4 of the left ventricle into the aorta, pushes the 
 44 valves of that artery upon the orifices of the ar- 
 44 tcrke coronariae, so that no blood can enter into 
 44 the substance of the heart ; thus both causes of 
 
ARTERIES AND VEINS. 
 
 199 
 
 « Contraction failing, this muscle must become pa- 
 « ralytic. The resistance then to the contraction of 
 the auricles being now removed, they will throw 
 « their blood into the ventricles ; and the impulsion 
 <e of blood into the arteries from the heart now also 
 cc ceasing, the two great arteries will be consfcrict- 
 “ ed : the nerves are therefore now again free from 
 <£ compression, and the valves of the aorta being 
 i£ thrust back upon the mouth of the ventricle, the 
 <£ blood enters the arterise coronariae ; since the ven- 
 <s tricles are again supplied with both the liquids 
 “ on which their contraction depends, they must 
 “ again act. And thus as long as these causes con- 
 C£ tinue, their effects must follow, i. e. as long as- 
 s ‘ the creature lives, the heart must have an al- 
 <£ ternate systole and diastole, and the auricles and 
 “ ventricles have reciprocal actions.” 
 
 If the arteries contract, suppose a fourth part 
 of the squares of their diameters at every systole, and 
 if the heart does not throw out a quantity at every 
 systole, equal to the fourth part of the solid con- 
 tents of all the arteries when dilated, it is evident 
 the heart does not throw the blood through the 
 whole arterial system, but into so much of the ar- 
 teries nearest the heart, as will contain four times 
 as much as is thrown out of the left ventricle at 
 once : and then this portion of arteries throws the 
 blood forwards and dilates the arteries that lie next, 
 and so on : but if the capacities of all the arteries 
 taken together in their utmost dilatations, exceed 
 
200 
 
 arteries and veins. 
 
 their capacities in their utmost contractions, just Sc* 
 much as the quantity of blood amounts to, which 
 is thrown out of the left ventricle of the heart at 
 every systole, which I believe is the case, then every 
 contraction of the heart propels the blood through 
 the whole arterial system, which may be the reason 
 why the largest animals, cxteris paribus, have the 
 slowest pulses and least vigour in their motions, and 
 perhaps too for the same reason require a less pro- 
 portion of food. The sections of all the remoter 
 vessels being greater than a section of the aorta, 
 the blood will move so much slower in the lesser 
 vessels than in the greater, as the sections of the 
 lesser vessels taken together exceed the section of 
 the greater vessel or vessels. The strength of the 
 coats of the arteries, if the blood pressed equally 
 against the sides of them all, cseteris paribus, ought 
 to be one to another as their circumferences, be- 
 cause so much as the circumference of one artery 
 is greater than another, so much greater pressure 
 its sides must sustain ; but the arteries nearest the 
 heart, sustaining the reaction of all the arterial 
 blood, they must have a- strength yet greater than 
 in that proportion ; and the vessels, both arteries 
 and veins, the more distant they are from the 
 head, the greater proportional strength their coats 
 must have, because the arterial and venal blood 
 communicating, they will press upon the lower 
 vessels, with a force proportional to the perpendic- 
 ular altitude of blood above, which will be that of 
 
ARTERIES AND VEINS.' 
 
 201 
 
 the perpendicular altitude of the whole body ; for 
 though the ascending blood of the arteries may be 
 said not to press upon the descending, because it 
 moves another way, nevertheless, it being thrown 
 from the heart into one common vessel, which af- 
 terwards divides, the blood moving both ways com- 
 municates, and that force which is necessary to 
 overcome the natural inclination of the ascending 
 blood to descend, will be impressed also upon the 
 descending blood, which is just the same with the 
 weight of the ascending blood ; and the veins both 
 from above and below communicating at the right 
 auricle, the pressure in them will also be as the 
 perpendicular altitude of the body. So that the 
 blood in all the veins and arteries may be compared 
 to a fluid in a curved tube, in which that part in 
 one leg exactly balances that in the other, and both 
 pressing most upon those parts which are nearest 
 the centre of the earth. Accordingly we And by 
 experience, that humours are most apt to flow to 
 the lowest parts, and that by laying those parts upon 
 a level with the whole body, this inconvenience is 
 remedied ; but laying a leg only on a chair does it 
 but in part, just so much as the perpendicular alti- 
 tude of the body from that part is shortened. There 
 is also to be considered concerning the thickness 
 of the coats of the vessels, that the blood moving 
 slower in the small vessels than in the great, the mo- 
 ment of the blood against the sides of a small vessel 
 will be as much less than the moment of the blood 
 
202 
 
 ARTERIES AKD VEINS. 
 
 against equal parts of a great one, as the velocity of 
 the blood in a small vessel is less than that in a great 
 one ; and therefore their coats may also differ from 
 the former proportion, as the velocity of the blood 
 differs. Most of the small vessels in the limbs ly- 
 ing against one another are a mutual support, and 
 therefore less liable to be dilated or burst than ca- 
 pillaries which lie in the thin membranes of cavi- 
 ties, such as in the nose. Hence these, I suppose, 
 are most subject to haemorrhages. And if haemor- 
 rhages of blood do frequently arise from obstruc- 
 tions in the minutest vessels, does it not appear how 
 opium and the bark, if they thin the blood inwardly 
 taken (as they do most powerfully when mixed 
 with it) come to be so often effectual remedies in 
 that case ? And the coats of the lesser vessels being 
 proportionably weaker than the great ones, accord- 
 ing to the decrease of the velocity of the blood, 
 which lessens the moment with which it moves in 
 them, whenever the blood begins to move in them 
 with an equal velocity, or greater, as it happens 
 after an amputation, when the larger vessels are tied, 
 the force of the blood sometimes overcomes the 
 strength of the coats of the smaller vessels, and di- 
 lates them so that those vessels which scarce bled 
 during the operation, will sometimes bleed after- 
 wards. And this constant effort of the blood to 
 dilate vessels upon the obstructions of others may 
 cause those throbbing pains which are felt in 
 wounds when the bleeding is stopped, and in alh 
 
ARTERIES AKD VEINS. 
 
 203 
 
 violent inflammations, until the collateral branches 
 are dilated, or the tension of the parts otherwise 
 taken off. 
 
 The extreme branches both of the arteries and 
 veins have very numerous communications, like 
 those in the stamina of the leaves of plants, by 
 which communications the blood that is obstruct- 
 ed in any vessels may pass off by other vessels that 
 are not obstructed 5 and the moment of the blood 
 in the vessels lessening, and the friction from the 
 vessels increasing as it approaches the extremities 
 and as many of the lesser vessels are more exposed 
 to pressure than any of the large ones, those com- 
 munications in the lesser vessels are therefore made 
 more numerous. By means of these communica- 
 tions, the blood circulates in a limb that has had 
 part amputated, and into any vessels that have 
 been separated from the trunks that supplied 
 them, which otherwise must have mortified for 
 want of nourishment, and with them, for the 
 same reason, all the branches that arise from such 
 separated vessels ; and I can discern no other way 
 than by these communications, that the fluids 
 contained in a large inflammation can suppurate 
 into one cavity. 
 
 If we inject by the arteries a large quantity of a 
 coloured fluid, we And all the large veins full of 
 that liquor before any of the solid parts are much 
 coloured with it ; and upon frequent repetitions ail 
 #fthem much less coloured than, I think, might be 
 
204 
 
 ARTERIES AND VEINS. 
 
 expected, if it had gone into all the vessels of the 
 body ; and I have often thrown wa$ or tallow, 
 coloured with vermilion or verdigrise, through 
 all the arteries, and back again through the veins, 
 even to the heart, every where filling vessels that 
 cannot be discerned without a microscope ; and all 
 this without filling or much discolouring any one 
 entire part. In viewing with a microscope the cir- 
 cultion of the blood in the tail of a fish, the eye 
 easily traces arteries to their extremities, and their 
 return in veins ; yet all the vessels we can see make 
 but a small part of the whole of what we see ; 
 though we are taught that the whole animal body 
 is a compages of vessels, such as we see : but if it 
 were so, I think, we could not well distinguish any ; 
 and if the sum of the diameters of all the vessels 
 we can see, are to that of the breadths and thick- 
 nesses of all the rest of the parts, which we see at 
 the same time, taken together, but as one to five, 
 these vessels then are no more than the twenty 
 fifth part of what we see with them. What then 
 shall we suppose the rest of the tail, and those parts 
 which were so little tinged, and those which were 
 not filled with wax, in the foregoing experiments, 
 composed of ? Are they not composed of vessels 
 which arise from the arteries, as excretory ducts do 
 In a gland, but terminate in the veins ? And these 
 vessels being only to convey the nutritious juices, 
 and what else may be a proper vehicle for them, 
 is it not fit the circulation in them should be ex* 
 
ARTERIES AND VEINS. 
 
 205 
 
 ceeding slow, that the nutritious particles may ad- 
 here the easier to the fibres of the vessels, which 
 they are to augment or repair ? Besides, if any 
 whole part was made up of blood vessels, or any 
 other vessels with fluids moving swiftly in them, it 
 seems to me impossible, that one part of a limb can 
 be very cold while another part is hot, if the warmth 
 of the parts is owing to the fluids they contain. 
 And if there are such vessels as these, the velocity 
 of the motion of their fluids will not depend upon 
 any proportion they bear to the vessels they arise 
 from, but upon the velocity with which their fluids 
 are separated from the arteries into them, and the 
 proportion of the sections of all their orifices to 
 the sum of their own sections, at any distance 
 where we would compare the velocity of their 
 fluids. And the strength of the coats of these ves- 
 sels mav not onlv be as much less than the strength 
 of the coats of on artery, as their diameters are 
 less, but also less in that proportion in which the 
 velocity of their fluids is less, and the motions more 
 uniform, than the velocity and motion of the blood 
 in an artery. 
 
 The coats of the veins are much thinner than 
 those of the arteries, comparing vessels whose sec- 
 tions are equal, because the blood moving slower 
 in the veins than in the arteries, it presses with less 
 moment against their sides : and besides, the blood 
 in the veins has nearly an equal uniform motion, 
 but jn the arteries a very unequal one ; and that 
 
206 
 
 ARTERIES AND VEINS. 
 
 will require a farther difference in the strength of 
 their coats ; for those of the arteries must be equal 
 to the greatest natural pressure ; and if the arterial 
 blood propels the venal, that is a farther reason for 
 the different strength of their coats. 
 
 All these things being considered, it appears to 
 be a difficult thing to determine nearly, what pro- 
 portion the fluids of an animal body bear to the 
 solids, or what proportion the sum of all the mi- 
 nutest arteries bear to the aorta, without which, I 
 think, we can neither determine the comparative 
 velocity of the blood moving in the different vessels, 
 nor the quantity of blood in any animal body, nor 
 the time in which the whole mass of blood, or a 
 quantity equal to the whole mass, is flowing through 
 the heart. But if each ventricle of the heart holds 
 five ounces of blood, and they are filled and emp- 
 tied every systole and diastole, which, I think, is 
 true, and if eighty pulses in a minute be allowed 
 to be a common number, there then flows twenty- 
 five pounds of blood through each ventricle of the 
 heart in a minute. Dr. Keil has shewn that the 
 sum of all the fluids in a man, exceed the sum of 
 all the solids, and yet the quantity of blood which 
 all the visible arteries of a man will contain, is less 
 than four pounds ; and if we may suppose all the 
 visible veins, including the vena portae, hold four 
 times as much, the whole then that the visible ves- 
 sels can contain is not twenty pounds ; but the whole 
 that they do contain is but very little more than the 
 
ARTERIES AND VEIN'S. 
 
 207 
 
 veins can contain, seeing the arteries are always 
 found almost empty in dead bodies ; but how much 
 the invisible arteries and veins contain, I mean those 
 which contain such a compound fluid as is found 
 in the larger vessels, I know no way to judge, un- 
 less we knew what proportion these vessels bear to 
 those that carry the nutritious juices and serum (if 
 there are such) without the globuli of the blood. 
 Cteteris paribus, is not the velocity of the blood in 
 all animals proportionable to their quantity of 
 action ; and their necessity of food also in propor- 
 tion to their quantity of action ? If so, it appears 
 how those animals which use no exercise, and whose 
 blood moves extremely slow in the winter, can sub- 
 sist without any fresh supply of food ; while others 
 that use a little more exercise, require a little more 
 food ; and those who use equal exercise winter and 
 summer, require equal quantities of food at all 
 times ; the end of eating and drinking being to re- 
 pair what exercise and the motion of the blood has 
 destroyed or made useless ; and is not the less ve- 
 locity of the blood in some animals than in others, 
 the reason why wounds and bruises in those ani- 
 mals do not so soon destroy life, as they do in ani- 
 mals whose blood moves swifter ? 
 
 I had a patient whose muscles on the inside 
 of the thigh were torn to pieces with the cramp, 
 from whence was a vast effusion of blood among 
 the muscles. The tumour being opened, it was 
 judged necessary to take off the limb. The pa- 
 
203 
 
 ARTERIES AND VEINS'. 
 
 tient, having a great discharge from the wotmcf^ 
 was easy for about ten days ; but the cramp then' 
 returned into the stump with such excessive tor- 
 ment that he died soon after. I have never heard 
 btLt of one other case of this kind, which ended in 
 the same manner. 
 
 When any of the vessels are lacerated by bruises, 
 strains, or otherwise, without any external, wound, 
 purging (which is of more use than one can well 
 account for) and cooling applications are always 
 proper to prevent as much as may be extravasations 
 of blood or serum ; but the lacerations once healed, 
 which may be in eight or ten days, and the pain 
 quite gone, then warm medicines may be applied,, 
 with opium, or sp. cornu cervi (which powerfully 
 separate coagulated fluids) to help to attenuate and 
 thereby dissipate the extravasated juices. 
 
 When the blood vessels become unable to pre- 
 serve the circulation in the extreme parts, whether 
 from particular weakness in the vessels, or any 
 other decay, I have always observed it to be hurtful 
 to scarify. It lets out the juices that should assist 
 nature to make a separation of the mortified part 5 
 nor can it be known in what place we may safely 
 amputate till such a separation which teaches us 
 where it can be supported, and in any place short 
 of that, an operation will be both useless and mis- 
 chievous. I have known many succeed well who 
 have been thus left to separate, but very few that 
 were otherwise treated ; nay, have known some 
 
LYMPII AEDUCTS. 
 
 209 
 
 extraordinary instances of success where the patient 
 had the happiness to have no one about them to in- 
 terrupt the kind assistance of mature. 
 
 CHAPTER X. 
 
 OF THE LYMPHiEDUCTS. 
 
 JLi YMPHaEDUCTS are small pellucid cylindri- 
 cal tubes, which arise invisible from the extremi- 
 ties of the arteries throughout the whole body, 
 but more plentifully in glands than other parts, 
 and in greatest number from such glands as separate 
 the most viscid fluids, as may be observed in the liver 
 and testes- They cannot be discerned in a natural 
 state to have more than one coat, and that exceed- 
 ing thin, having valves at small and uncertain dis- 
 tances, to prevent the regress of their fluid. They 
 have frequent communications like the veins, but 
 do not unite so often ; the larger trunks are in many 
 places attended with small glands, through which 
 they run, and at the same time send communicant 
 branches over them, that they might be secured 
 against obstructions from diseases in those glands- 
 They all terminate in the vasa lactea, or in the large 
 veins. All that rise in the abdomen empty into the 
 venae lacteae secundi generis and receptaculum chyli ; 
 those in the cavity of the thorax into the ductus 
 thoracicus and the subclavian veins. Their uses are 
 d d 
 
210 
 
 LYMPH A EDUCES. 
 
 to carry lymph to dilute the chyle, to make It in- 
 corporate more readily with the blood (but not to 
 make it flow the better in the lacteals, as appears 
 sufficiently from their not entering into the minutest 
 lacteals) and to carry off* so much lymph as is 
 necessary to leave the blood in fit temper to flow 
 through the veins ; for it is always observed that in 
 such persons as have their blood too thin, the glo- 
 buli cohere and form moleculae, or polypuses, 
 which I imagine may arise from the globuli of the 
 blood not rubbing often enough, and with sufficient 
 force one against another to disunite them as fast 
 as they cohere. These polypuses are frequently 
 found in all the large veins, and in the right au- 
 ricle and ventricle of the heart, especially in such 
 bodies as die hydropic or of any chronic diseases. 
 
 Authors have described and painted these ves- 
 sels as they appear when injected with mercury j 
 in which case the coat of these vessels being exceed- 
 ing thin, it is not able any where between the valves 
 to resist the mercury’s attracting itself into globules : 
 and the same appearance also happens when they 
 are vastly distended ; because the valves hindering 
 a distention where they are seated, the spaces be- 
 tween them approach to a spherical figure from the 
 equal pressure of the fluid, according to the degree 
 of their distention : but in a natural state, when 
 they are filled with lymph, or when they are mod- 
 erately injected with air or water, they appear as 
 cylindrical as the veins. Any of these vessels being. 
 
ltmphaeducts. 
 
 211 
 
 burst, they cause a dropsy in the cavity into which 
 they open, which is oftener in the abdomen than the 
 thorax. This kind of dropsy is sometimes cured by 
 tapping, and I believe the reason why it no oftener 
 succeeds is, that it generally takes its rise from a dis- 
 eased liver. Formerly in this operation only part of 
 the water was drawn off at a time, and the tap some- 
 times left in the wound to draw off more, which 
 was exceeding painful, and sometimes brought on 
 a mortification ; and if they drew off much water 
 at one time the patient was in great pain, and gen- 
 erally fainted, which was thought to proceed from 
 the loss of too much of the liquor at once. But 
 Dr. Mead, observing that these symptoms could not 
 proceed from the loss of an extravasated fluid, 
 soon found the true cause, which was the sudden 
 want of the pressure of the abdominal muscles 
 against the parts contained in the abdomen ; and 
 in the year 1705, being then physician to St, 
 Thomas’s hospital, ordered it to be tried there in 
 the following manner : he directed the abdomen 
 to be pressed by the hands of assistants while the 
 water was running out, and afterwards kept rolled 
 till the muscles recovered force to do their office, 
 and so took out all the water at once, without any 
 inconvenience, which has made this operation not 
 very painful, sometimes successful, and never dan- 
 gerous. I preserved one woman, by sixteen ope- 
 rations, from the fifty sixth year of her age to eigh- 
 ty ; another six years by sixty six tappings ; it 
 
212 
 
 LYMPHATIC GLANDS. 
 
 piust be confessed, that few cases succeed like these, 
 and very few recover. 
 
 1 opened a woman, who died of a dropsy in 
 the liver, in which I found the gibbous part en- 
 tirely wasted, and the coat of the liver about a 
 quarter of an inch thick, which contained about 
 five gallons of a gross yellowish fluid, in which 
 were many hydatids about the size of gooseberries, 
 and some pieces of matter of as bright a red as ver- 
 milion. At about fourteen years of age she first 
 began to feel pain in this part, which returned 
 monthly, but in time grew continual, her belly 
 constantly increasing till she died, which was in 
 the twenty eighth year of her age, without ever 
 having had her menses. All the other viscera both 
 fin the thorax and abdomen were perfectly sound, 
 nor was there the least sign of the dropsy in any 
 of the limbs, or yellowness in the skin, which is 
 frequent in diseases of the liver. 
 
 CHAPTER XI. 
 
 OF THE LYMPHATIC GLANDS. 
 
 The glands accompanying the lymphatics 
 are situated in the three cavities, in the inter- 
 stices of the muscles, where the lymphatics lie with 
 the large blood vessels, and in the four emuncto- 
 ries, viz, the arm pits and groins. In the brain 
 
LYMPHATIC CLANDS. 
 
 213 
 
 
 
 
 
 is seated the glandula pinealis, which I judge to 
 be of this sort, having often seen large lymphaeducts 
 running into it from the plexus choroides ; and at 
 the basis of the brain in the cella turcica is the glan- 
 dula pituitaria, into which enters a large lymphatic, 
 as I imagine, named infundibulum (vid. chap. Of 
 the brain.) In the neck are situated a great many 
 of these, by the sides of the carotid arteries and in- 
 ternal jugular veins, and two, or a sort of double 
 one, upon the larynx, immediately below the thy- 
 roid cartilage, from which situation they derive the 
 name of thyroidese ; and just within the thorax is 
 seated another, called thymus. In very young chil- 
 dren the thymus is as large, or larger, than the thy- 
 roic glands ; but in men these glands are very large, 
 and the thymus very small, the former having in- 
 creased in about a double proportion of any other 
 gland of this kind, and the latter having rather di- 
 minished than increased ; but in brutes, such as 
 have fallen under my observation, it is just the con- 
 trary. From which observations I am inclined to 
 conclude, that they both belong to the very same 
 lymphatics, and that either of them increasing as 
 much as both ought to do if both increased, an- 
 swers the same end as if both did ; and that the 
 reason why the thymus increases rather than the 
 thyroid glands in brutes, is because the shape of 
 their thorax affords convenient room for it to lodge 
 in ; and that in men the thyroid glands increase 
 so much, because there is no room in that part of 
 
214 
 
 LYMPHATIC GLANDS. 
 
 the thorax where the thymus is seated for a large 
 gland to be lodged. In dogs, a porpoise, and some 
 other animals, I have seen the lymphatics in the 
 thymus, and between the thymus and ductus tho- 
 racicus, full of chyle, and so in many other lym- 
 phatics near the vasa lactea. Under the basis of the 
 heart, and at the sides of the lungs, where the great 
 vessels enter, are many of these glands, from the size 
 of a pea to that of a hazel nut. In the abdomen, 
 upon the loins, near the kidneys, and by the sides of 
 the iliac vessels, are many of these glands, which are 
 called lumbales ; and there are some at the hollow 
 side of the liver named hepaticae : the mesentery 
 also is full of glands of a like appearance ; but these 
 seem to belong only to the lacteal veins, unless some 
 of them, which are seated at the basis of the me- 
 sentery, among the venae lacteae secundi generis, 
 belong to the lymphatics that come from the liver, 
 where the hepatic lymphatics pass in their way to 
 the receptaculum chyli. The glands which accom- 
 pany the blood vessels in the limbs are few, and 
 distributed in no certain order ; except those in the 
 four emunctories, i. e. in the arm pits and groins, 
 named axillares and inguinales. 
 
 Brutes have one laree one in the thigh, com- 
 monly called the pope’s eye ; this is seated about 
 the great vessels in the thigh, where they pass 
 through the triceps muscle. From this situa- 
 tion, and not from any thing extraordinary in this 
 gland, it is that wounds are there so dangerous. 
 
LYMPHATIC GLANDS. 
 
 215 
 
 The lymphatic glands are said by Nuck, and 
 others after him, to be composed of vesicles, and 
 not of vessels like other glands ; and that these ve- 
 sicles are repositories of lymph : but from their 
 appearance in a natural state, which is very com- 
 pact and uniform, there seems to me to be but little 
 reason for such a conjecture. Some have thought 
 their use to be by contracting to accelerate the mo- 
 tion of the fluid in the lymphatics ; but that does 
 not seem very probable, because a muscular coat 
 would have been the readiest means to produce that 
 effect ; besides, those vessels seldom enter any of 
 them without detaching a branch over at the same 
 time, perhaps to prevent obstructions. And if these 
 glands were endued with a contracting power, which 
 is only presumed without any proof, it would still 
 be difficult to conceive how such a power, applied 
 at uncertain spaces, should not rather obstruct than 
 accelerate the motion of lymph in the lymphatics, 
 unless there were valves to prevent a reflux ; and 
 even then, if this were a convenient piece of me- 
 chanism, it would be strange it should no where else 
 in the body be made use of. 
 
 These lymphatic glands being diseased, are apt 
 to obstruct and occasion the bursting of the lym- 
 phatics that pass through them ; which, if in the 
 breast, causes an incurable hydrops pectoris ; if in 
 the abdomen, the true ascites, attended with a wast- 
 ing of the limbs,, which is never cured, but may be 
 relieved by tapping. 
 
216 
 
 COURSE OF THE 
 
 CHAPTER XII. 
 
 OF THE COURSE OF THE ALIMENT AND FLU- 
 IDS, ABSTRACTED FROM THE FOREGOING CHAP- 
 TERS. 
 
 Teie aliment being received into the mouth, is 
 there masticated, and impregnated with saliva, 
 which is pressed out of the salivary glands by 
 the motions of the jaw and the muscles that move 
 it and the tongue. Then it descends through the 
 pharynx into the stomach, where it is digested by 
 the juices of the stomach (which are what is 
 thrown out of the glands of its inmost coat, and 
 saliva out of the mouth) and a moderate warmth 
 and attrition. Then it is thrown through the py- 
 lorus or right orifice of the stomach into the duo- 
 denum, where it is mixed with bile from the gall- 
 bladder and liver, and the pancreatic juice from 
 the pancreatic gland. These fluids serve farther to 
 attenuate and dilute the digested aliment, and prob- 
 ably to make the fluid part separate better from 
 the feces. After this it is continually moved by 
 the peristaltic motion of the guts, and the com- 
 pression of the diaphragm and abdominal muscles, 
 by which forces the fluid parts are pressed into the 
 lacteals, and the gross parts through the guts to the 
 anus. 
 
 The chyle, or thin and milky part of the ali- 
 ment, being received into the lacteals from all the 
 
ALIMENT AND ELUID3. 217 
 
 small guts, they carry it into the receptaculum chy- 
 li, and from thence the ductus thoracicus carries it 
 into the left subclavian vein, where it mixes with 
 the blood, and passes with it to the heart. 
 
 All the veins being emptied into two branches, 
 viz. the ascending and descending cava, they empty 
 into the right auricle of the heart ; the right auri- 
 cle unloads into the right ventricle, which throws 
 the blood through the pulmonary artery into the 
 lungs ; from the lungs the blood is brought by the 
 pulmonary veins into the left auricle, and from 
 that into the left ventricle, by which it is thrown 
 into the aorta, and distributed through the body. 
 From the extremities of the arteries arise the veins 
 and lymphatics ; the veins to collect the blood and 
 bring it back to the heart ; and the lymphatics to 
 return the lymph, or thinner part of the blood, from 
 the arteries to the veins and the vasa lactea, where it 
 mixes with the chyle, and then passes with it into 
 the left subclavian vein and to the heart. 
 
 All the fluids that pass into the stomach and 
 guts being carried into the blood vessels, the great- 
 est part of them are separated and carried off by- 
 proper vessels, viz. urine from the kidneys, bile 
 from the liver, &c. and these juices carry along 
 with them whatever might be injurious to the 
 animal economy. 
 

 218 DUKA MATEJU 
 
 CHAPTER XIII. 
 
 OF THE DURA MATER AND PIA MATER. 
 
 D URA mater is a very compact, strong mem- 
 brane, lining the inside of the scull, firmly ad- 
 hering at its basis, and but lightly at the upper 
 part, except at the sutures. It has three processes ; 
 the first, named falx, begins at the crista galli, 
 and runs backwards under the suture sagittalis to 
 the cerebellum, dividing the cerebrum into two 
 hemispheres. Its use is said to be to support one 
 side of the cerebrum from pressing on the other 
 when the head is inclined to one side. But I 
 think it is evident that this is not the use, because 
 there would be more need of such a process from 
 one side of the scull to the other, than this way ; 
 and it would also be very necessary that it should 
 run through the brain, to answer that end. The 
 principal use appears to me to be, to divide the brain 
 into such portions as are least liable to be moved 
 in the scull, by any violent motions of the head, 
 which is better done this way than it would the 
 other ; and the under side of the brain is kept steady 
 by the inequalities of the basis of the scull, which 
 the brain is exactly fitted to. In brutes the falx 
 is always very small, therefore in those whose 
 brains are of the larger size, as oxen; sheep, horses, 
 &c. the upper part of the scull is made uneven, 
 exactly to fit the folds of the brain which secures- 
 
BUR A MATER, 
 
 219 
 
 the upper parts of their brains from concussions, in 
 .the same manner that the lower parts are secured. 
 The second process runs from the lower and back 
 part of the former to the upper edge of each os 
 petrosum, and sustains the posterior lobes of the 
 cerebrum, that they might not compress the cere- 
 bellum. In such rapacious animals as I have dis- 
 sected, this process is bone. The third is very 
 small ; it runs from the last described process down 
 towards, the great foramen of the scull, and possesses 
 the small space in the cerebellum, between the pro- 
 cessus vermiformisc These processes of the dura 
 mater also serve to keep the brain steady. 
 
 The dura mater has in it several sinuses, which 
 are large veins to receive the blood from the lesser 
 veins of the brain : their number is uncertain, and 
 those that are constant are not described in the 
 same order by writers. The first that presents itself 
 is the longitudinalis superior, running from a blind 
 hole a little above the crista galli all along the 
 upper edge of the falx. A transverse section of 
 this vessel is not circular, like other vessels, but a 
 triangle, whose sides are arches of a circle ; the 
 upper side convex outwards, and the two lower 
 convex inwards. The figure of this vessel is pre- 
 served by small ligaments running across in the in- 
 side, that it might not become conical, or cylindri- 
 cal, like other vessels, from the equal pressure of 
 the contained blood, and thereby incommode the 
 upper edges of each hemisphere of the cerebruigu 
 
220 
 
 DURA MATER. 
 
 On the lower edge of this process is generally an* 
 other very small one, called longitudinal! s inferior ; 
 this runs into the rectus, and when wanting is 
 supplied by a vein ; the rectus runs between the two 
 first processes of the dura mater, and unloads with 
 the sinus longitudinalis superior into the two later- 
 al sinuses ; but for the most part the longitudinal 
 sinus goes more directly into one of the lateral si- 
 nuses, and the straight sinus into the other. There 
 is sometimes a small one in the third process, which 
 empties in the same place with the former. From 
 the endings of the longitudinal and aight sinuses, 
 begin the two lateral sinuses, which, when they 
 come to the os petrosum, dip down and pass through 
 the eighth foramina into the internal jugular veins. 
 There is another named circularis ; it runs round 
 the fore part only of the cella turcica ; the two 
 ends of this empty into four sinuses, one on the 
 top of each os petrosum, which pass into the sinus 
 lateralis, and one at the under sides of the same 
 bones, which pass indifferently into both the late- 
 ral and cervical sinuses ; these two last sinuses have 
 always communicant branches. The cervical si- 
 nuses run from the basis of the scull through the 
 great foramen on both sides of the medulla spi- 
 nalis colli, and through the transverse processes of 
 the cervical vertebrae ; the last of these have many 
 times proper foramina running from the eighth 
 foramina to the back part of the apophyses of the 
 occipital bone. There are also two more of these 
 
PIA MATER. 
 
 221 
 
 vessels, which run from the circular sinus between 
 the os sphenoides and fore part of the os petro- 
 sum directly into the internal jugular veins. 
 
 Pia mater is an exceeding fine membrane im- 
 mediately investing the brain, even between its 
 lobes, hemispheres, and folds. It serves to contain 
 the brain, and support its blood vessels, which run 
 here in great numbers, for the arteries to divide 
 into small branches upon, that the blood may not 
 enter the brain too impetuously : and for the veins 
 to unite on, that they may enter the sinuses in 
 fewer and larger branches. Between the dura 
 and pia mater, is described, by several anatomists, 
 a membrane called arachnoides, which may easily 
 be shewn at the back part of the cerebrum, upon 
 the cerebellum and back part 'of the medulla 
 spinalis. 
 
 I have seen a large part of the dura mater, and 
 once part of the pia mater ossified. 
 
CEREBRUM. 
 
 CHAPTER XIV. 
 
 OF THE CEREBRUM, CEREBELLUM, MEDULLA OB- 
 LONGATA, AND MEDULLA SPINALIS. 
 
 Cerebrum is that part of the brain which 
 possesses all the upper and fore part of the 
 cranium, being separated from the cerebellum 
 by the second process of the dura mater. Its 
 upper side is divided into two hemispheres, and its 
 lower side into four lobes, two anterior and two 
 posterior, which latter are much the largest. At 
 the meeting of the four lobes appears the infundi- 
 bulum, which seems to be a lymphatic, running 
 from the ventricles of the brain into the glandula 
 pituitaria : this gland is seated in the cella turcica. 
 Immediately behind the infundibulum appear two 
 small bodies, named protuberantise duae albae pone 
 infundibulum. Between the two hemispheres of 
 the cerebrum, lower than the circumvolutions, 
 appears a white body named corpus callosum. 
 Under the corpus callosum appear the two lateral 
 or superior ventricles, which are divided into right 
 and left by a very thin membrane, named septum 
 lucidum, which is extended between the corpus 
 callosum and fornix. The fornix is a medulla- 
 ry body beginning from the fore part of thes,e 
 ventricles, with two small roots which soon unite ; 
 and running towards the back part, where they 
 divide into parts, called crura fornicis. In the 
 
CEREBELLUM. 
 
 223 
 
 basis of these two ventricles are four prominences : 
 The two anterior are called (from their inner tex» 
 ture) corpora striata ; the other two are named 
 thalami nervorum opticorum. Beyond these are 
 two more processes, called nates ; and under them, 
 nearer the cerebellum, two called testes. Above 
 the nates is situated the glandula pinealis, famous 
 for being supposed by Des Cartes, the seat of 
 the soul. And upon the thalami nervorum opti- 
 corum are a number of blood vessels, glands, and 
 lymphseducts, called plexus choroides. Under the 
 beginning of the fornix is a small hole, called fo- 
 ramen ad radices fornices, or iter ad infundibulum ; 
 and under the middle of the fornix, one called fo- 
 ramen posterius, which is covered with a valve 
 named membrana, or valvula major ; and the space 
 I under the two anterior ventricles between the for- 
 amina and the cerebellum is the third ventricle. 
 
 Cerebellum is situated under the second process 
 of the dura mater. By dividing this part of the 
 brain lengthways we discover more plainly the 
 fourth ventricle, whose extremity is called calamus 
 scriptorius ; here also appear two medullary bod- 
 ies called pedunculi, which are the basis of the 
 cerebellum. The medullary part in the cerebellum, 
 though it is inmost, as in the cerebrum, yet is of a 
 different shape, being branched out like a plant. 
 
 The substance of the brain is distinguished into 
 outer and inner : the former is called corticalis, ci- 
 nerea, or glandulosa ; the latter medullaris, alba, or 
 
 nervea. 
 
224 MEDULLA OBLONGATA^ &X. 
 
 Medulla oblongata is a medullary continuation 
 of the under part of the cerebrum and cerebellum * 
 It first appears in two bodies from the anterior 
 part of the posterior lobes of the cerebrum, call- 
 ed crura medulla oblcngatae. The union of these 
 crura between the cerebrum and cerebellum is 
 called isthmus ; and immediately beyond this is 
 an eminence named processus annularis. 
 
 Medulla spinalis is a production of the medulla 
 oblongata through the great foramen of the scull, 
 and through the channel of the spine : it enlarg- 
 es about the last vertebrae of the back and first of 
 the neck, where the large nerves are given off to 
 the arms : it again enlarges in the loins, where the 
 crural nerves begin ; and the lower end of it, with 
 those and other nerves, is called from its resem- 
 blance cauda equina. The coats of this part are 
 the same with those of the brain ; but the mem- 
 brane here, which is analogous to the dura mater, 
 is thinner and more connected to the bones, and 
 the tunica arachnoides more conspicuous. 
 
 Wounds in the cerebrum, though very danger- 
 ous, are not mortal ; but in the cerebellum and 
 medulla oblongata cause sudden death ; and in the 
 medulla spinalis, loss of sense in all the parts which 
 receive nerves from below the wound. In persons 
 that have died lethargic, I have always found the 
 brain full of water : and in children, the brain is 
 always very soft and moist. In a man, that died 
 of an apoplexy, I found all the vessels of the brain 
 
NERVES. 
 
 225 
 
 immoderately distended with blood, and the ventri- 
 cles and the substance of the brain full of lymph, 
 the pia mater very much thickened, and adhering 
 so very loosely that the greatest part of it was 
 separated without breaking. 
 
 I have twice seen in the cerebrum a scirrhous 
 tumor as large as a pullet’s egg ; and in another 
 body, imposthumations which possessed near two 
 thirds of the whole cerebrum. And in a person 
 that died with a gutta serena, I found all the ven- 
 tricles of the brain full of lymph ; and the tha- 
 lami nervorum opticorum and the optic nerves, ere 
 they went out of the scull, made flat with the pres- 
 sure. And in an old man I found the right optic 
 nerve wasted and black. 
 
 CHAPTER XV. 
 
 OF THE NERVES. 
 
 “ F ROM the medullary part of the cerebrum, 
 “ cerebellum, and medulla spinalis, a vast num- 
 “ ber of small medullary white fibres are sent 
 “ out, which, at their first egress, seem easily to 
 “ separate, but as they pass forward are somewhat 
 “ more, but still loosely connected, by the coat 
 “ which they obtain from the pia mater, and at 
 “ last piercing the dura mater, are straitly braced 
 “ by that membrane which covers them in their 
 
 “ progress ; whence they become white, firm, 
 E f 
 
226 
 
 NERVES. 
 
 44 strong cords, and so, are well known by the 
 44 name of nerves. To these coats an infinite num- 
 44 ber of vessels, both arteries and veins, are dis- 
 44 tributed ; so that after a nice lucky injection the 
 44 whole cord is tinged with the colour of the in- 
 44 jected liquor : but when the fibrils are examined, 
 44 even with the best microscope, they appear only 
 44 like so many small distinct threads running pa- 
 44 rallel, without any cavity observable in them, 
 “ though some incautious observers, mistaking the 
 44 cut orifices of the arterious and venous vessels, 
 44 just now mentioned, for nervous tubes, have af- 
 44 firmed their cavities to be visible. The nerves, 
 44 which if all joined hardly make a cord of an inch 
 44 diameter, would seem, from their exerting them- 
 44 selves everywhere, to be distributed to each, even 
 44 the smallest part of the body. In their course 
 44 to the places for which they are destined, they 
 44 generally run as straight as the part over which 
 44 they are to pass, and their own safety from exter- 
 44 nal injuries, will allow, sending off their branch- 
 “ es at very acute angles, and consequently run- 
 44 ning more parallel than the blood vessels. Their 
 44 distribution is seldom different in the opposite 
 44 sides of the same subject, nor indeed in any 
 44 two subjects is there considerable variety found. 
 44 Frequently nerves which come out distinct or 
 44 separate, afterwards conjoin into one fasciculus, 
 44 under the same common covering ; and though 
 44 the nervous fibrils probably do not communicate 
 
NERVES. 
 
 22 1 
 
 44 (the reason of which opinion shall immediately 
 “ be given) yet because the coats at the conjoined 
 44 part are common, and these strong coats may 
 44 have great effects on the soft pulpy nerves, it is 
 44 evident all such will have a considerable sympa- 
 44 thy with one another, v/hereof several exam- 
 44 pies in practice shall be instanced when the par- 
 44 ticular nerves are described. In some parts 
 44 where there are such conjunctions, the bulk of 
 44 the nerves seems much increased, and these 
 44 knotty oval bodies, called by Fallopius cor- 
 44 pora olivaria, and generally now named gang- 
 44 lions, are formed. The coats of these knots 
 44 are stronger, thicker, and more muscular than 
 44 the whole nerves which enter into them would 
 44 seem to constitute, while the nervous fibrils 
 44 pass through without any great alteration or 
 44 change. I do not think any author has yet 
 44 made a probable conjecture of the use or design 
 44 of these ganglions, whether they imagine them 
 44 corcula expellentia, reservoirs, or elaboratories, 
 44 neither can I give an account of their use the 
 44 least satisfactory to myself. 
 
 44 From undeniable evident experiments, all an- 
 44 atomists are now convinced that to the nerves 
 44 we owe all our sensation and motion, of which 
 44 they are the proper organs ; and the sensations 
 44 in the minutest parts being very distinct, there- 
 <4 fore the instruments of such sensations must have 
 distinct origins and course to each part. Though 
 
228 
 
 NERVES. 
 
 44 all are agreed as to the effect, yet a hot dispute 
 44 has arisen about the manner how it is produced, 
 44 viz. whether sensation and motion are occasioned 
 “ by a vibration communicated to the nerves, which 
 44 these gentlemen suppose entirely solid and tense, 
 44 or by a liquid contained and moved in them. 
 44 The last of these opinions I rather incline to, for 
 “ these reasons, because the nerves proceeding from 
 44 the brain bear a great analogy to the .excretory 
 44 ducts of other glands. Then they are far from 
 44 being stretched and tense in order to vibrate. 
 44 And what brings the existence of a liquid in their 
 44 cavities next to a demonstration is the experiment 
 44 first made by Bellini, and related by Bohn 
 44 and Pitcairn, which I have often done with 
 44 exact good success ; it is this : After opening the 
 44 thorax of a living dog, catch hold of and compress 
 44 the phrenic nerve, immediately the diaphragm 
 44 ceases to act ; remove the compressing force, that 
 44 muscle again contracts ; gripe the nerve with one 
 ££ hand some way above the diaphragm, that sep- 
 “ turn is unactive ; then with the other hand strip 
 44 clown the nerve from the first hand to the dia~ 
 £C phragm, this muscle again contracts ; after once 
 44 or twice having stripped the nerve thus down 
 44 or exhausted the liquid contained in it, the mus- 
 44 cle no more acts, squeeze as you will, till the 
 44 first hand is taken away or removed higher, and 
 44 the nerve stripped, i. e. the liquids in the supc- 
 rior part of the nerve have free access to the dia- 
 
NERVES. 
 
 229 
 
 « phragm, or are forced down to it, when it again 
 t( will move. Now if this liquid should be granted 
 “us, I am afraid we shall be still as much at a 
 “ loss to account for sensation and motion as ever ; 
 “ and therefore all I shall assume is what is found- 
 “ ed on experiments, that these two actions do de- 
 “ pend on the nerves ; that sensations are pleasant 
 “ as long as the nerves are only gently affected 
 C£ without any violence offered them ; but as soon 
 “ as any force applied goes beyond this, and 
 “ threatens a solution of union, it creates that 
 “ uneasy sensation, pain : the nerves, their source 
 “ or their coats being vitiated, either convulsion or 
 <e palsy of the muscles may ensue. 
 
 “ The nerves are distinguished into two classes, 
 “ of the encephalon and medulla spinalis ; of the 
 <£ first there are generally ten pair reckoned, of 
 “ the last thirty. I shall describe the nerves in 
 “ the same order in which they are generally 
 “ ranked, though it is not possible to prosecute the 
 “ dissection of them after the same manner ; but 
 “ to supply this, I shall mention also the order 
 “ wherein they may be all demonstrated on one 
 “ subject. When I assign the origin of any nerve 
 “ from any particular part, I desire it may be un- 
 u derstood of that part of the surface of the me- 
 “ dulla, where the nerve first appears ; for by this 
 “ method we shall shun any dispute with those au- 
 “ thors who trace their rise too minutely, and per- 
 haps be less liable to mistake or to deceive our 
 
230 
 
 NERVES. 
 
 44 readers. Nor shall I be over anxious about the 
 44 terminations of the minima; fibrillre, since it is 
 44 not possible to trace them ad ultimos fines, nor 
 44 do I think it very necessary for explaining any 
 44 phaenomena, while very often in a multiplicity of 
 44 words the whole description comes to be obscure 
 cc or unintelligible. 
 
 o 
 
 44 Of the ten pair proceeding from the encepha- 
 44 Ion, the first is the olfactory, which in brutes, 
 44 justly enough, has the name of processus ma- 
 44 millares bestowed on them, being large and hol- 
 44 low, and are indeed evidently the two anterior 
 44 ventricles of the brain produced ; which structure 
 44 and the lymph constantly found in them, induced 
 44 the ancients to believe that they served as emunc- 
 44 tories to convey the superabundant mucus from 
 44 the cold moist brain to the nose ; but in man 
 44 they are small, long, and without any cavity, 
 44 rising from that part of the brain where the ca- 
 44 rotid arteries are about to enter, and running un- 
 44 der the anterior lobes of the brain become a little 
 44 larger, till they reach the os tribriforme, into 
 44 the foramina of which the small filaments in- 
 44 sinuate themselves, as upon gently pulling those 
 44 nerves, or after having cut them very near the 
 44 bone, is evident, and are immediately spread on 
 44 the membrana narium. Their tender structure 
 44 and sudden expansion on such a large surface, 
 44 make it impossible to trace them on the mem- 
 44 brane of the nostrils, which has given some handle 
 
NERVES. 
 
 231 
 
 44 to several authors to deny them the structure or 
 44 use of nerves. 
 
 “ The second are the optic, which arise single 
 44 from the thalami nervorum opticorum, and then 
 44 uniting at the fore part of the cella turcica, they 
 44 seem to be pretty much blended ; afterwards they 
 44 divide, and running obliquely forwards, pass out 
 44 at their proper hole of the sphenoide bone, and 
 44 enter the globe of the eye to be expanded into 
 44 the membrana retina. From this conjunction of 
 44 these nerves, authors generally endeavour to ac- 
 44 count for our seeing objects single, whereas we 
 44 have reason to believe fishes, the chamseleon, &c. 
 44 whose optic nerves simply cross one another with- 
 44 out any such union, do see objects also single, 
 44 since they so exactly rush on their prey ; where- 
 44 as if those authors’ assertions were true, they 
 44 would oftener catch at the shadow than the sub- 
 44 stance. The blood vessels running through the 
 44 middle of these nerves, and the ramifications of 
 44 the retina are very observable, whence we may 
 44 deduce the reason of Picard’s experiment of 
 44 such objects as fall on the entry of the optic nerve 
 44 being lost to us ; and hence also an account may 
 44 be given of an amaurosis or gutta serena. 
 
 44 The third pair of nerves first appear at the 
 44 anterior part of the processus annularis, and go- 
 44 ingout at the foramen lacerum, are distributed to 
 44 the globe of the eye ; musculus rectus Fallopii, 
 44 attolens, adducens, deprimens, and obliquus mi- 
 
232 
 
 NERVES. 
 
 “ nor ; therefore this pair has justly got the name 
 “ of motores oculi. 
 
 “ The fourth pair, which are the smallest of 
 “ any, derive their origins from the anterior lateral 
 “ part of the processus annularis, and go out at the 
 “ foramina lacera to be entirely spent on the mus* 
 “ culi trochleares, or obliqui majores oculorum, 
 “ to which muscles chiefly the rotatory motion of 
 “ the eyes in ogling, and the advance of the eyes 
 “ forward in staring and fury, is owing ; for 
 44 which reason anatomists have called these nerves 
 44 pathetici. 
 
 44 The fifth pair arise from the sides of the an- 
 44 nular process, and after piercing the dura mater 
 44 divide into three branches ; the first of which is 
 44 the ophthalmic, which as it is about to enter 
 44 the orbit by the foramen lacerum, sends off a 
 44 small twig that assists in the formation of the 
 44 intercostal, and then the nerve is distributed to 
 “ the glandula lacrymalis, fat membranes, and pal- 
 44 pebrse of the eye, while it sends one considerable 
 44 branch through the orbiter internus anterior hole 
 ^ 4 to be lost in the membrana narium, and a second 
 44 passes the foramen and supercilia to supply the 
 44 muscles and teguments of the forehead. Hence 
 44 we easily discover what part is affected in that 
 44 painful disease the megrim, when the eyeball 
 44 and forehead are racked, and such a heat is felt 
 44 within the nose. Hence also we may learn how 
 44 the muscles of respiration come to be so much 
 
NERVES* 
 
 233 
 
 f£ affected on the application of any acrid irritating 
 * 4 substance to the membrana narium, as to pro* 
 * c duce that violent convulsive motion, sneezing, 
 “ The second branch of the fifth pair, which may 
 s ‘ be called maxillaris superior, passes out through 
 “ the foramen rotundum ossis sphenoidis, and im« 
 “ mediately gives nerves to the fat under the cro« 
 cc taphite muscle, and to the palate, sinus sphenoi- 
 “ dalis, and nostrils. The remaining trunk insinu- 
 “ ating itself into the channel on the top of the 
 “ antrum Higlnnorianum, to which cavity and to 
 c< the teeth of the upper jaw it gives small twigs, 
 “ at last comes out at the orbiter externus hole, 
 u and is spent on the musculus orbicularis palpebra- 
 “ rum, nose, and upper lip, where some branches 
 “ of the seventh pair seem to unite themselves to 
 s ‘ the twigs of this. The third branch, or maxil- 
 “ laris inferior, goes out at the foramen ovale, or 
 “ fourth hole of the wedge-like bone, and soon 
 “ splitting into a great many branches, is distrib- 
 “ uted to the musculus crotaphites, masseter, pte- 
 <c rygoides, digastricus, buccinator, mylohyoideus, 
 “ geniohyoideus, genio-glossus, and basio-glossus, 
 “ glandula sublingualis, maxillaris inferior, and pa- 
 “ rods, to the external ear, where it seems to join 
 “ the pordo dura to the substance of the tongue, 
 “ in which it is pretty much confounded with the 
 C{ ninth pair : from the root of this last branch the 
 “ chorda tympani is reflected. The last ramifica- 
 “ tion oT this branch which I shall mention, is 
 0 g 
 
234 
 
 SERVES. 
 
 44 that which enters into the canal of the lower jaw 
 “ furnishes the teeth there, and comes out at the 
 “ chin, on which and the lower lip it is bestowed ; 
 “ at this place it is again conjoined to the seventh 
 44 pair. From this short sketch of the large fifth 
 “ pair of nerves, and by observing several phaenom- 
 “ ena which happen to those parts to which they 
 44 are distributed, we might have a much farther 
 44 confirmation of the general doctrine of nerves 
 44 delivered, and see, at least, the way pathed to a 
 44 rational account of these phenomena, for reason- 
 44 ing on which we should not otherwise have the 
 44 least ground. We can, for example, from the 
 44 chorda tympani and the nerves of the teeth, bc- 
 44 ing derived from the same common trunk, un- 
 44 derstand how the sound of any vibrating body 
 64 held between our teeth is sensible to us, when 
 44 another cannot possibly hear the least of it. By 
 44 the like rule we know why in a violent tooth- 
 44 ache the muscles of the face are sometimes con- 
 44 vulsed ; nor shall we be surprised to hear one 
 44 plagued with the ache in his upper teeth, com- 
 44 plain of a gnawing pain deep seated in the bones 
 44 of his face, or to see his eyelids much swelled, 
 “ or the tears trickling down in great abundance ; 
 44 whereas the lower teeth aching, the ear is pain- 
 “ ed, and the saliva flows in great quantities. We 
 <c may have some distant views of some foundation 
 44 in reason for the cure of the toothache, by strong 
 44 compression of the chin, or by applying blisters. 
 
N-LRVES. 
 
 23 S 
 
 ** behind the ears, or by burning behind or on the 
 “ ear. Among a great many instances of the good 
 “ effect of the actual cautery in such a case, I shall 
 “ give one which seems to be remarkable : I. M. 
 “ was seized with the toothache, a convulsion of 
 “ that whole side of his face followed whenever 
 “ the pain became acute, or he attempted to 
 <s speak ; after he had undergone bleeding, purg- 
 ^ ing, salivation, setons, &c. without any benefit, 
 <c he was cured by applying a small cauterising 
 “ iron to the antihelix. 
 
 “ The sixth pair of n-erves arising from the fore 
 <c part of the corpora pyramidalia, after piercing 
 “ through the dura mater, give off a branch, 
 ei which, joined with the reflected twig of the oph- 
 “ thalmic branch of the fifth pair, forms the origi- 
 “ nal of the intercostal, passes through the fora- 
 “ men lacerum to be spent entirely on the mus- 
 tc cuius abductor oculi : supposing this nerve to 
 <c supply ever so little less than a due proportion 
 * c of liquidum nervosum, an involuntary strabis- 
 “ mus will be occasioned. 
 
 “ Though the fifth and sixth pair of nerves 
 cc form entirely the beginning of the intercostal be- 
 <c fore it goes out of the scull, yet because several 
 tc other nerves contribute towards the formation of 
 Ci its trunk before it sends off any branches, I shall 
 “ supersede the description of it till the original 
 nerves are spoke to. 
 
236 
 
 NEKVES. 
 
 44 The seventh pair appears coming out from 
 44 the side of the root of the annular process, and 
 44 entering the meatus auditorius interims, and 
 44 immediately dividing, one part soon loses its 
 44 firm coats, and is expanded on the inmost ca- 
 64 mera of the ear, while the other passing through 
 44 the aquoeductus Fallopii comes out of the scull 
 44 involved in all its coats between the styloide and 
 44 mastoide processes ; whence we see the reason of 
 44 the first being named portio mollis, i\nd the 
 44 other dura : this last after its exit supplies the 
 44 musculi obliqui capitis stylohyoidei, styloglossi, 
 44 and stylopharyngeei, and platysma myoides, on 
 44 which, and to the skin of the neck, a great num- 
 44 ber of its small filaments run, which are somc- 
 44 times cut in opening the jugular vein, whence 
 44 pain at first, and a little numbness afterward. 
 44 The superior branches of it supply the parotid 
 44 gland, external ear, and whole side of the face 
 44 as far forwards as the chin. It is said to corm 
 44 municate thrice with the fifth pair, and twice 
 44 with the second vertebra. Whether may not we 
 44 hence see some reason why the head is so soon 
 44 moved by the impression of sound on our ear ? 
 
 44 The eighth pair of nerves derive their origin 
 44 from the side of the basis of the corpora olivaria, 
 44 where their loose filamentous texture is very con- 
 44 spicuous ; then running to the hole common to 
 44 the ossa temporum and occipitis, they are there 
 54 joined by the accessorius WiUisii, which has its 
 
NERVES. 
 
 237 
 
 « beginning from the two or three superior nerves 
 44 of the medulla spinalis, and mounts upwards 
 44 thither, to pass out with the eighth pair, at that 
 44 common foramen just now mentioned : very 
 44 soon after they, wrapped up in the same coat, 
 44 have got out of the cranium, the accessorius sep- 
 44 arates from its companion, and after passing 
 44 through the middle of the musculus mastoideus, 
 44 is lost in the musculus trapezius and rhomboides 
 44 scapulae ; while the large trunk, which, from the 
 44 great number of branches it sends off, obtains 
 44 the name of vagus, runs straight down the neck, 
 44 near the carotid artery, in its course giving seve- 
 44 ral branches to the larynx : when entered the 
 44 thorax, it splits into two ; the anterior serves the 
 44 pericardium, sends branches to join with those 
 44 of the intercostal that go to the heart, and then 
 44 on the right side turns round the subclavian, and 
 44 on the left round the ductus arteriosus, to mount 
 44 again upwards at the side of the oesophagus to 
 44 be lost in the larynx. This recurrent branch it 
 44 is that we are earnestly cautioned to avoid in 
 44 bronchotomy, though by reason of its deep situ- 
 44 ation we are in no hazard of it. If both these 
 44 nerves were cut, it is probable the voice -would 
 44 not be entirely lost as long as the superior branch- 
 44 es still supply the larynx. The posterior branch 
 44 of the eighth pair goes along with the oesophagus, 
 44 and supplies the lungs, the gula, and stomach 
 44 very plentifully ; and as all the nerves bestowed 
 
238 
 
 NERVES. 
 
 44 on this viscus enter at the superior orifice of it, 
 64 the sensation here must be very acute ; whence 
 44 Helmont imagined the mouth of the stomach 
 44 to be the seat of the soul. What remains of 
 44 this par vagum is adjoined to the intercostal im- 
 44 mediate below the diaphragm. 
 
 44 The ninth pair appear first at the inferior 
 44 part of the corpora pyramidalia, and march out 
 44 at their proper holes of the occipitis, and after 
 44 sending off some nerves to the glandula thyroi- 
 44 dea, and musculi sterno-hyoidei, and sterno^ 
 44 thyroidei, are lost in the substance of the tongue. 
 44 Authors have disputed whether this ninth or 
 44 the fifth is the gustatory nerve ; the old opinion 
 44 in favour of the ninth is to me most probable, 
 44 because the fifth is no where else employed as 
 64 an organ of sensation, because the ninth seems to 
 44 penetrate the substance of the tongue more, while 
 44 the fifth is spent on the muscles. 
 
 44 The tenth pair comes out from the beginning 
 44 of the medulla spinalis, betwixt the os occipitis 
 44 and first vertebra colli, and is all, except what 
 44 goes to the ganglion of the intercostal, spent on 
 44 the musculi obliqui, and extensores capitis. 
 
 44 The only nerves proceeding from the ence- 
 44 phalon not described, are the reflected branches 
 44 of the fifth and sixth, which indeed are so small 
 44 and pappy, and hid by the carotid artery as they go 
 54 out with it in its crooked canal, as not to be easily 
 44 traced ; but whenever they have escaped from the 
 
■JfERVESi 
 
 233 
 
 u os petrosum, they are joined by branches from 
 4t the eighth, ninth, tenth, and first and second 
 “ spinal, and the largest ganglion of the body is 
 “ formed, from which the nerve named now in- 
 “ tercostal, goes out to descend down the neck 
 <c with the carotid, supplying in its course the mus- 
 “ culi flexores of the head and neck, and commu- 
 “ nicating with the cervical nerves. As the inter- 
 “ costal is about to enter the thorax, it auain forms 
 s< a ganglion, from which the nerves to the trachea 
 “ arteria and the heart are supplied, which join with 
 “ the branches of the eighth, and pass between the 
 “ two large arteries and auricles to the substance 
 “ of that muscle. Now let any one consider the 
 “ egress of the intercostal, and close course of it 
 <s and the eighth with the carotid artery, and this 
 “ manner of entry of the cardiac nerves, surely 
 “ the alternate constriction and relaxation of the 
 <c heart will appear necessarily depending on the 
 “ disposition of these organs of motion, the nerves. 
 “ The intercostal after this runs down on the side 
 M of the vertebras thoracis, having additional nerves 
 <c constantly sent to it from between these verte- 
 “ brae, till it pass through its own proper hole of 
 te the diaphragm y whence it again forms another 
 “ ganglion close by the glandulas renales, into 
 <c which the eighth pair enter. From such a knot 
 “ on each side, the nerves of the guts, liver, spleen, 
 “ pancreas, and kidneys are derived ; nay, the ex - 
 (i tremity of this nerve is sent down to the pelvis 
 
240 
 
 MERVES. 
 
 I 
 
 44 to supply the parts there. Hence the great syrru 
 44 pathy of these parts may be easily deduced, and 
 44 a reason may be given of the violent vomiting 
 44 that commonly attends a nephritis, and of the 
 44 belching, colic, and stomach aches, which often 
 44 ensue on the obstructions of the menstrua. 
 
 44 Before I proceed to the spinal nerves, I 
 44 shall set down the order in which these nerves 
 44 already described, are to be dissected, in order 
 44 to demonstrate them all in one subject, but to 
 44 them must assume the three first cervical nerves, 
 
 44 the reason of which will be evident afterwards. 
 
 44 Portio dura septimi, frontalis quinti, facia- 
 44 lis quinti, mentalis quinti, spinalis sccundus, 
 
 44 spinalis primus, olfactorius, ophthalmicus quin- 
 44 ti, motorius oculi, patheticus sextus, opticus, 
 
 44 maxillaris inferior quinti, maxillaris superior 
 44 quinti, accessorius Willisii, nonus, decimus, oc- 
 44 tavus intercostalis, portio mollis septimi. 
 
 44 The thirty pair of nerves proceeding from 
 44 the medulla spinalis are generally divided into 
 44 four species ; of the neck seven, of the back 
 44 twelve, of the loins five, and of the os sacrum 
 44 six. Now as the medulla spinalis has none of 
 44 these inequalities so observable on the medulla 
 44 oblongata encephab, the rise of the nerves is not 
 44 so accurately described, being only determined by 
 44 the bone through which they pass. 
 
 44 The first cervical goes out between the first 
 44 and second vertebra, and, after sending off branches 
 
 
NERVES. 241 
 
 <e that communicate with the tenth and second 
 “ vertebrale, is spent on the musculus flexus colli, 
 “ splenius, complexus, and teguments of the occi-* 
 u put. 
 
 “ The second cervical communicates with the 
 ec ninth, and with the first and third of the neck, 
 ec and then is distributed to the teguments of the 
 6i neck and side of the head, and to the glandula 
 fiC parotis and external ear, where it joins with the 
 cs portio dura. 
 
 “ The third of the neck passes out between the 
 “ third and fourth vertebra, soon communicating 
 “ with the second* and sending down a large 
 “ branch, which being joined by another from 
 cc the fourth forms the phrenic nerve that runs 
 “ along the pericardium to be lest in the dia- 
 te phragm. In this course the right phrenic is o« 
 “ bliged to make a small turn round that part of the 
 “ pericardium which covers the apex of the heart. 
 “ Hence it is that such as have strong palpita- 
 fi tions of the heart feel a pungent acute pain im- 
 “ mediately above the right orifice of the stomach. 
 u The other branches of this third cervical are 
 “ distributed to the musculus trapezius and del- 
 “ toides, and to the teguments on the top of the 
 <c shoulder ; which, with the description of the 
 “ eighth pair, leads us evidently to the reasons of 
 “ the divine Hippocrates’s observation, that an. 
 “ inflammation of the liver is generally attend- 
 ed with a hiccough, and a suppuration of that 
 h h 
 
 U 
 
242 
 
 NfcELVES. 
 
 cc viscus, with a violent pain on the top of the 
 “ shoulder. However, we are not hence to con- 
 <c elude so generally, as I have observed physicians 
 (i frequently do, that if the hypochondria are ef- 
 “ fected, and this pain of the shoulder is felt, there- 
 “ fore the liver is suppurated ; for any other cause 
 “ stimulating or stretching the nerves, such as in- 
 <c flammation, wounds, scirrhous or steatomatous 
 “ tumours, &c. may produce the same effect. 
 
 “ The fourth cervical, after sending off that 
 cc branch which joins with the third to form the 
 “ phrenic, runs straight to the axilla, where it 
 <c meets with the fifth, sixth, and seventh cervicals, 
 <c and first dorsal that escape in the interstices of the 
 “ musculi scaleni ; and all of them are so often 
 “ conjoined and blended, after they have given off 
 “ nerves to the muscles of the neck, scapula, arm, 
 “ and thorax, and to the teguments, that when the 
 “ several ramifications go off in the axilla to the 
 “ different parts of the superior extremity, it is im- 
 “ possible to determine which of them the branches 
 “ belong to. The considerable branches into which 
 “ they are divided, are six ; these I shall presume to 
 u give proper distinguishing names to, by which the 
 “ description will be less confused, and the young 
 “ anatomist’s memory better assisted to retain what 
 “ is so difficult to represent in words. 
 
 “ 1. Cutaneus runs down the fore part of the 
 “ arm, and serves the teguments, as far as the palm 
 “ of the hand and fingers. 
 
VERVES. 
 
 243 
 
 « 2. Musculo-cutaneus, or perforans casserii, 
 passes through the musculus coracobrachialis, and 
 i( after supplying the biceps and brachiasus internus 
 “ is spent on the teguments of the back of the cu- 
 “ bitus and liand. 
 
 “ 3. Muscularis, that runs down the fore part 
 “ of the arm to be lost in the musculi flexores carpi, 
 “ digitorum, &c. 
 
 “ 4. Ulnaris, which supplies the extensores 
 “ cubiti, and teguments of the elbow, and then 
 “ passing through the sinuosity at the back of the 
 “ external condyle of the humerus, runs along the 
 “ ulna, where it gives twigs to the teguments and 
 “ neighbouring muscles ; at length is lost in the 
 “ back of the hand, musculi interrossei, and lumbri- 
 “ cales in the little finger, and side of the ring 
 “ finger next to this. The course of this nerve is 
 “ sufficiently felt when we lean on our elbow, by 
 “ the insensibility and prickling pain in the parts 
 u to which it is distributed. 
 
 “ 5. Radialis goes down the fore part of the 
 arm, near the radius, bestowing branches in its 
 “ progress on the circumjacent muscles, and at the 
 “ ligamentum annulare carpi splitting, is sent to 
 <c the thumb, fore finger, middle finger, and half 
 “ the ring finger, and to the back of the hand. 
 
 “6. Articularis runs almost round the top of 
 <c the os humeri, and serves the musculi ' exten- 
 sores cubiti, retractores, and elevatores humeri, 
 
244 
 
 NERVES. 
 
 44 By a strong and continued pressure on these 
 44 nerves, by crutches or any such hard substance, 
 44 a palsy and atrophy of the arm may be occa- 
 44 sioned. 
 
 44 The twelve dorsal nerves all communicate 
 44 with one another : as soon as they make their 
 44 way out betwixt the vertebrx, each of them 
 44 gives a posterior branch to the musculi erectores 
 44 trunci corporis ; the first, after having sent off 
 44 the brachial nerve, already described, is, after the 
 44 same manner with the succeeding eight, be- 
 44 stowed on the pleura and intercostal muscles ; the 
 44 tenth and eleventh are most of them sent to the 
 44 abdominal muscles ; the twelfth communicates 
 44 with the first lumbar, and is bestowed on the 
 44 musculus quadratus lumbalis and iliacus internus. 
 
 44 The fifth lumbar also communicates and gives 
 44 posterior branches -, the first sends several branches 
 44 to the abdominal muscles, and psoas, and iliacus, 
 44 while others go from it to the teguments and 
 44 muscles on the superior and anterior part of the 
 44 thigh, and the main trunk of it is lost in the 
 44 crural. The second passes through the psaos 
 44 muscle, and is distributed much as the former. 
 44 The third is lost in the musculus pectineus. 
 44 Branches proceeding from the first, second, and 
 44 third, make up one trunk, which runs along the 
 44 anterior part of the pelvis, and slipping through a 
 44 small sinuosity in the anterior part of the foramen 
 f 4 magnum ossis ischii, is spent in the musculus 
 
SERVES. 
 
 245 
 
 <c triceps. This nerve is commonly known by the 
 44 name of obturator, or posterior crural nerve. 
 44 By the union of branches from the first, second, 
 “ third, and fourth lumbar nerves, the anterior 
 44 crural nerve is formed, which running along the 
 44 musculus psoas, escapes with the large blood 
 64 vessels, out of the abdomen below the tendinous 
 44 arcade of its muscles, and is distributed to the 
 44 muscles and teguments on the fore part of the 
 44 thigh : one branch of this crural nerve accom- 
 44 panics the vena saphena as far as the ancle. Now 
 44 let us imagine the situation of the kidney upon, 
 44 and the course of the ureter over these nerves, 
 44 and we shall not be surprised, that in a nephritis 
 44 the trunk of the body cannot be raised erect 
 44 without great pain ; that the thigh loses of its 
 44 sensibility, and that it is drawn forwards. The 
 44 remainder of the fourth and the fifth lumbar 
 44 nerves join with the first, second, and third that 
 44 proceed from the os sacrum : these five, when 
 44 united, constitute the largest nerve of the body, 
 44 so well known by the name of the sciatic, or 
 44 ischiatic nerve, which seems to be bigger, in 
 44 proportion to the part for the use of which it is, 
 44 than the nerves of any other part are ; the de- 
 44 sign of which may be to afford sufficient strength 
 44 to the muscles of the lower extremity, for cx- 
 44 erting a force superior to what is required in any, 
 44 other part of the body. When this nerve is any 
 44 way obstructed, we see how unable we are to 
 
245 
 
 NERVES. 
 
 ee support ourselves, or to walk. The sciatic nerve 
 44 then goes out at the large hollow behind the 
 cc great tubercle of the os ischium, and passing 
 44 over the quadrigemini muscles, runs down the 
 44 posterior part of the thigh, giving off, every 
 44 where as it goes, nerves to the teguments and 
 44 muscles of the thigh and leg. At the ham it 
 44 splits into two ; the smaller mounts over the fi- 
 44 bula, and serving the musculi peronei, flexores 
 44 pedis, and extensores digitorum, is continued to 
 “ the toes along the broad of the foot, while the 
 44 larger trunk sinks under the musculi gemclli, 
 44 and then divides ; one is spent in the muscles 
 44 at the back of the leg and teguments, while 
 44 the other is continued by the inner ancle to the 
 44 foot, and then subdivides ; one branch is distrib^ 
 44 uted after the same manner as the ulnaris, and 
 44 the other as the radialis in the hand. 
 
 44 The other nerves that come out of the os sa- 
 44 crum, are sent to the organs of generation, mus- 
 44 culi levatores ani, and obturatores. 
 
 44 These nerves of the medulla spinalis may all 
 44 be dissected and demonstrated in the same order 
 44 in which they are described.” For this accurate 
 description of the nerves I am obliged to Mr. 
 Monro. 
 
 The nerves seem, when examined with a mi- 
 croscope, to be bundles of strait fibres not commu- 
 nicating with one another : and I am inclined to 
 think, that every the minutest nerve terminating 
 
NERVES. 
 
 247 
 
 in any part, is a distinct cord from its origin in the 
 brain or spinal marrow ; or else I do not see how 
 they could produce distinct sensations in every part : 
 and the distinct points of sensation throughout the 
 body are so very numerous, that the whole body of 
 nerves (which taken together would not make a 
 cord of an inch diameter) must be divided into such 
 a number, to afford one for every part that has a 
 distinct sensation, that surely such a nerve would 
 be too small to be seen by the best microscope. 
 They all pass in as direct courses to the places they 
 serve, as is possible, never separating nor joining 
 with one another but at very acute angles, unless 
 where they unite in those knots which are called 
 ganglions, the use of which I do not pretend to 
 know ; they make what appears to be a communi- 
 cation of most of the nerves on the same side, but 
 never join nerves on opposite sides. 
 
 That the nerves are instruments of sensation, 
 is clearly proved from experiments, but how they 
 convey those sensations to the brain, is matter of 
 dispute. The most general opinion is ; that they 
 are tubes to contain animal spirits, by whose mo- 
 tions these sensations are conveyed : and diligent 
 inquiry has been made to discover their cavities, 
 but hitherto in vain ; and if each nerve is distinct 
 from its origin, as I have endeavoured to shew, and 
 too small to be the object of the best microscope, I 
 do not see how such cavities are like to be discov- 
 
NERVES. 
 
 £48 
 
 ered. Nevertheless nerves may be tubes, and 
 possibly a fluid, whose cohesion is very little, and 
 whose parts, no finer than light, may move freely 
 in them. Those who deny animal spirits in the 
 nerves, suppose that the sensation is conveyed by a 
 vibration. To which it is objected, that they are 
 slack, moist, and surrounded with soft parts, and 
 are therefore unfit for vibrations, as indeed they 
 are for such as are made on the strings of a musi- 
 cal instrument ; but the minutest vibrations, such 
 as they cannot be without, may, for aught we 
 know, be as suflicient for this end, as the impulse 
 of light upon the retina, is for the sense of seeing. 
 So that perhaps sensations may be conveyed ei- 
 ther, or both ways. However, it being usually 
 taken for granted, that it must be one of these 
 ways at least, the advocates for each have rather 
 endeavoured to support their opinions by argu- 
 ments against the probability of the other, than by 
 reasons offered for their own. 
 
TAB. XXI 
 
 
 
TABLES. 
 
 249 
 
 TABLE XXL 
 
 1 Larynx. 
 
 2 The internal jugular Vein. 
 
 3 The subclavian vein. 
 
 4 Cava descendens. 
 
 5 The right auricle of the heart, 
 
 6 The right ventricle. 
 
 7 Part of the left ventricle. 
 
 8 Aorta ascendens. 
 
 9 Arteria pulmonalis. 
 
 10 The right lobe of the lungs, part of which is 
 
 cut off to shew the great blood vessels. 
 
 11 The left lobe of the lungs. 
 
 12 The diaphragm. 
 
 13 The liver. 
 
 14 The ligamentum rotundum. 
 
 15 The gall-bladder. 
 
 16 The stomach, pressed by the liver towards the 
 
 left side. 
 
 17 The small guts. 
 
 18 The spleen. 
 
250 
 
 TABiES. 
 
 TABLE XXIL 
 
 1 The under side of the liver, 
 
 2 Lisjamentum rotundum. 
 
 3 The gall-bladder. 
 
 4 The pancreas. 
 
 5 The spleen. 
 
 G The kidney. 
 
 7 Aorta ascendens. 
 
 8 Vena cava ascendens. 
 
 9 The emulgent vein. 
 
 10 A probe under the spermatic vessels and the 
 
 arteria mesenterica inferior, and over the 
 ureters. 
 
 11 The ureter. 
 
 12 The iliac vessels. 
 
 13 The rectum intestinum. 
 
 14 The bladder of urine. 
 
TAB .xxir. 
 
TAB .XXIII. 
 
 r. i 
 
TABLES,. 
 
 251 
 
 TABLE XXIII. 
 
 1 Part of the intestinum jejunum. 
 
 2 The valvulae conniventes, as they appear in a dri- 
 
 ed preparation. 
 
 3 The venae lacteae arising from the gut, and pass- 
 
 ing through part of the mesentery. 
 
 4 Part of the descending aorta. 
 
 5 Arteria coeliaca. 
 
 6 Mesenterica superior. 
 
 7 Emulgentes. 
 
 8 Spermaticae. 
 
 9 Some of the branches of the mesenterica inferior 
 
 that are bestowed upon the guts. 
 
252 
 
 TABLES. 
 
 TABLE XXIV. 
 
 1 Extreme branches of the ven^ porta, as they 
 
 arise from the guts. 
 
 2 All the branches of the vena porta, united be- 
 
 fore it enters the liver- 
 
 3 The branches of the vena porta, as they are dis- 
 
 tributed in the liver. 
 
TA.B.XXIV- 
 
 P 2 52,- 
 
TAB. XXV. 
 
 -P. 2.5 II 
 
-TABLES. 
 
 253 
 
 
 
 TABLE XXV. 
 
 1 Brandies of the vena cava in the liver. 
 
 2 Part of the vena cava ascendens. 
 
 3 Part of the right auricle. 
 
 4 Cistis hepatica. 
 
 5 Ductus sisticus. 
 
 6 Ductus hepaticus. 
 
 7 Ductus pancreaticus. 
 
 8 The entrance of the ductus communis into the 
 
 duodenum. 
 
 
 ! 
 
254 
 
 tables. 
 
 TABLJE XXVI, 
 
 1 The left subclavian vein. 
 
 2 The internal jugular. 
 
 3 Part of the vena azygos. 
 
 4 Part of the descending aorta. 
 
 5 The subclavian artery. 
 
 6 Some of the lacteals entering the receptaculum 
 
 chyli. 
 
 7 Some lymphatics entering the receptaculum 
 
 chyli. 
 
 8, 9 The Ductus thoracicus. 
 
 10 The entrance of the thoracic duct into the sub- 
 clavian vein. 
 
TABLES. 255 
 
 TABLE XXVIL 
 
 1 The humeral artery. 
 
 2 Cubitalis superior. 
 
 3 Cubitalis inferior, which ends in the hand and 
 
 the fingers, and communicates with the 
 cubitalis superior, under the muscles of the 
 thumb. 
 
 4 The place where the cubitalis media is given 
 
 off. 
 
 5 The superior cubital nerve. 
 
 6 The inferior cubital nerve, which passes un- 
 
 der the inner extuberance of the os hu- 
 meri ; both these nerves give off branches 
 as they pass, and end in the thumb and 
 fingers. 
 
256 
 
 TABLES. 
 
 TABLE XXVIII. 
 
 1 Part of the biceps flexor cubiti. 
 
 2 The fascia tendinosa from that muscle, which 
 
 is liable to be pricked in bleeding in the ba- 
 silic vein. 
 
 3 The humeral artery, on each side of which is a 
 
 large vein. 
 
 4 Vena cephalica. 
 
 5 Mediana. 
 
 6 Basilica. 
 
 7 A tumor formed in the centre of the cubital 
 
 nerve, a little above the bend of the arm ; it 
 was of the cistic kind, but contained a trans- 
 parent jelly ; the filaments of the nerve were 
 divided and ran over its surface. This tu- 
 mor occasioned a great numbness in all the 
 parts that nerve leads to, and excessive pain 
 upon the least touch or motion. This opera, 
 tion was done but a few weeks since, the pain 
 is entirely ceased, the numbness a little in- 
 creased, and the limb, as yet, not wasted. 
 

 
 

 
 
 
 
 
TABLES. 
 
 257 
 
 TABLE XXIX. 
 
 1 The medulla spinalis, from whence arise the 
 
 nerves that pass out between the vertebrae. 
 
 2 The brachial nerves. 
 
 3 The beginning of the cauda equina. 
 
 4 The anterior crural nerves. 
 
 5 The posterior crural nerves. 
 
 6 The descending intercostal. 
 
 7 Nerves of the neck. 
 
 3 The brachial nerves. 
 
 9 A ganglion in the descending intercostal nerve. 
 
 10 Branches from the intercostal nerve to the 
 
 viscera. 
 
 11 A probe passed under some of the intercostal 
 
 nerves that pass out between the ribs. 
 
 12 The anterior crural nerves. 
 
258 
 
 TABLES. 
 
 TABLE XXX. 
 
 1 The animalculse in semine masculino, as they 
 
 appeared in a microscope, in a space as small 
 as a pin’s head. 
 
 2 The circulation of the blood in a fish’s tail, a& 
 
 it appeared in a microscope. 
 
 3 An artery, as it is spread in a membrane. 
 
 4 A vein, as it is spread in a membrane. 
 
THE 
 
 ANATOMY 
 
 OF THE 
 
 HUMAN BODY. 
 
 BOOK IK 
 
 CHAPTER I. 
 
 €>F THE URINARY AND GENITAL PARTS OF MEN, 
 TOGETHER WITH TEIE GLANDULE RENALES. 
 
 The urinary parts are the kidneys with their 
 vessels and bladder of urine. 
 
 The kidneys of men are like those of hogs ; 
 the two weigh about twelve ounces ; they are 
 seated towards the upper part of the loins upon 
 the two last ribs ; the right under the liver, and a 
 little lower than the other, and the left under the 
 spleen. Their use is to separate the urine front the 
 blood, which is brought thither for that purpose 
 
260 
 
 URINARY AND GENITAL 
 
 by the emulgent arteries ; and what remains from 
 the secretion, is returned by the emulgent veins, 
 while the urine secreted is carried off through the 
 ureters to the bladder. I have, in three different 
 subjects, taken stones out of the loins, which had 
 made their ways from the kidneys through the mus- 
 cles to the common integuments, where upon open- 
 ing the skin only, the stones appeared with a quan- 
 tity of matter and urine. We have heard of ope- 
 rators who have cut for the stone in the kidneys ; 
 but I will venture to affirm, that those cases were 
 no other than these, though unfairly related. 
 
 The ureters are tubes about the bigness of goose- 
 quills, and about a foot long ; they arise from the 
 hollow side of the kidneys, and end in the bladder 
 near its neck, running obliquely for the space of 
 an inch between its coats ; which manner of enter- 
 ing is to them as valves. The beginning of the 
 ureters in the kidneys are the tubuli urinarii, which 
 joining form the pelvis in each kidney. Between 
 the tubuli urinarii, authors have remarked small 
 papillae ; and the parts which are distinguished by 
 a clearer colour they call glandulae. 
 
 The bladder of urine is seated in a duplicature 
 of the peritonaeum in the lower part of the pelvis 
 of the abdomen ; its shape is orbicular, and its 
 coats are the same with those of the guts and other 
 hollow muscles already described ; viz. an external 
 membranous, a middle muscular, which is the mus^ 
 cuius detrusor urinae, and an inner membranous 
 
PARTS OF MEN. 
 
 261 
 
 coat, exceeding sensible, as is fully shewn in the 
 cases of the stone and gravel. The use of this 
 nice sense is to make it capable of that uneasiness 
 which excites animals to exclude their water, when 
 the bladder is extended. This sense is so delicate, 
 that no fluid but natural urine can be long endured, 
 even pale urine, or urine with matter in it, in a 
 degree excite the symptoms of the stone, and force 
 the person to void the urine. Sometimes much 
 matter from the kidneys will excite vehement symp- 
 toms ; and this being found in the urine, and the 
 pain being observed in the bladder only, the kidneys 
 having little sense of pain, it is usually accounted 
 for from ulcers in the bladder, which I have never 
 found one instance of in all the numbers that I have 
 opened in this case. Indeed the bladder is some- 
 times ulcerated, but that destroying part of the in- 
 ner coat, the others stretch and ulcerate till the urine 
 bursts through into the cellular membrane of the pe- 
 ritonaeum, and cause a most miserable death. This 
 case is very rare in men, and much more so in wo- 
 men. I have seen cancerous ulcers open the bladder 
 into the uterus, but these,’ I think, have begun in 
 the uterus. All these cases have symptoms like the 
 stone ; and not these only, but all diseases of the 
 uterus which disturb the bladder, and even impost- 
 humations or tumors that press upon the bladder, 
 all give the same symptoms with the stone ; except 
 that of a needless disposition to stool at the time of 
 making water. Some anatomists, not thinking how 
 
252 
 
 URINARY AND G£ni'TAL 
 
 soon fluids taken into the stomach, and not retained 
 there by being mixed with solids, may pass into the 
 blood, as the effects from drinking strong liquors or 
 laudanum, or drinking without eating when we are 
 hot, sufficiently shew ; and also not considering the 
 shortness of the course from the stomach to the kid- 
 neys this way, together with the size of the emul- 
 gent arteries, and the velocity of the blood in them 
 have imagined and affirmed, that there must be 
 some more immediate course from the stomach or 
 guts to the bladder ; and not considering either how 
 Such a course would have interrupted one great end 
 in the animal economy, or that vessels fit to fill 
 the bladder faster than the ureters, must have been 
 too large to be concealed ; nor, which proves it be- 
 yond contradiction, that the bladder is empty when 
 the kidneys cease to do their office ; which is fre- 
 quently taken for a suppression of urine in the blad- 
 der. If in this last case, upon making a pressure on 
 the region of the bladder, the patient does not feel 
 great pain, it is scarce worth while to pass a catheter to 
 search for urine. In suppressions of urine, wheth- 
 er merely inflammatory, or from the gout, or 
 from an inflamed stricture in the urethra, I have 
 found nothing so effectual as bleeding and purging. 
 In a sanguine large man, where the penis was too 
 much inflamed to suffer the catheter to pass, I took 
 away three times twenty-four ounces of blood, and 
 gave a purging clyster, and two strong purges, all 
 within the space of twenty hours, which saved 
 
PARTS OF MEN. 
 
 2 65 
 
 the patient, and delivered him from excessive tor- 
 ment. Such practice may seem very severe, but 
 in this case no time is to be lost ; if the urine can 
 be drawn off, the method of cure is still the same, 
 but to be practised in a gentler manner. 
 
 Glandulae renales are two glands seated imme- 
 diately above the kidneys, of no certain figure, 
 nor do we know their use ; but always paint and 
 describe them with the urinary parts, because of 
 their situation : in a very young foetus they are 
 larger than the kidneys, and in an adult but a little 
 larger than in a foetus. They receive a great many 
 small arteries, and return each of them one or two 
 veins. In their inside is a small sinus, tinctured 
 with a sooty-coloured liquor. 
 
 The testes are seated in the scrotum ; their of- 
 fice is to separate the seed from the blood ; they 
 are said to have four coats, two common, and 
 two proper. The common are the outer skin and 
 a loose membrane immediately underneath, called 
 dartos. The first of the proper is the processus va- 
 ginalis ; it is continued from the peritonaeum to the 
 testicle, which it encloses with all its vessels, but is 
 divided by a septum, or an adhesion immediately 
 above the testicle, so that no liquor can pass out of 
 that part of this membrane, which encloses the sper- 
 matic vessels, into that which encloses the testicle. 
 Large quantities of water are sometimes found in 
 either or both of these cavities, which disease is 
 easily remedied by a puncture with a lancet ; but 
 
 i 
 
264 - URINARY AND GENITAL 
 
 rarely cured without opening the cavity where the 
 water is contained, as in sinuous ulcers. This I 
 have done, and seen done several times, but never 
 thought the cure worth the trouble and pain the 
 patient underwent. The true hernia aquosa is from 
 the abdomen 5 which cither extends the peritonaeum 
 into the scrotum, or breaks it, and then forms a 
 new membrane which thickens as it extends, as in 
 aneurisms and atheromatous tumors. This may 
 be decided by an injection, which will shew by the 
 arteries that nourish it, whether it is a production 
 from the peritonaeum, or a new membranous bag 
 formed in the scrotum : however, the dropsy in 
 this cist, for such it properly is, rarely admits of 
 more than a palliative cure by puncture or tapping, 
 like the dropsy of the abdomen, and this with some 
 difficulty, because the omentum usually, and some- 
 times the gut, descends with it. The other proper 
 coat is the albuginea, which is very strong, imme- 
 diately enclosing the testicles. The testicles of a rat 
 may be unravelled into distinct vessels ; and the tex- 
 ture of the testicles of other animals appear to be 
 the same, but their vessels are too tender, or co- 
 here too much to be so separated. The testicles 
 receive each one artery from the aorta, a little be- 
 low the emulgents, which, unlike all other arte- 
 ries, arise small, and dilate in their progress, that 
 the velocity of the blood may be sufficiently abated 
 for the secretion of so viscid a fluid as the seed. The 
 right testicle returns its vein into the cava, and the 
 
ifARTS OR ME#.' 
 
 26$ 
 
 loft into the emulgent vein on the same side, both 
 because it is the readiest course, and because, as au- 
 thors say, this spermatic vein would have been ob^ 
 structed by the pulse of the aorta, if it had crossed 
 that vessel to go to the cava. 
 
 A gentleman, whom I castrated many years 
 since, who trusted too much to his own resolution, 
 and refusing to have any one present to hold him, 
 except my assistant, during. the operation, moved 
 so much, that the ligature which tied all the vessels 
 with the procees together, slipt, and only tied the 
 process over the ends of the vessels : which being 
 perceived soon after the operation, I cut the liga- 
 ture, and took out the extravasated blood, and tied 
 the artery alone, which gave but little pain, and it 
 digested off in a week’s time, and the wound being, 
 afterwards stitched, though the testicle weighed a 
 pound, it was perfectly well in five weeks ; which 
 is in less time than the ligature sometimes requires 
 to be digested off, when the process and all the 
 vessels are tied together. However, if this case is 
 not sufficient to recommend doing this operation 
 ■by tying the artery only, it may be sufficient to 
 recommend extraordinary care in doing of it die 
 usual way : for if the blood had found an easy 
 passage into the abdomen, the patient might have 
 bled to death. 
 
 On the upper part of the testicles, are hard 
 bodies called epididymi ; which are evidently the 
 beginning of the vasa deferentia. I have uft- 
 iA 
 
26G 
 
 urinary and genital 
 
 ravelled them backward, in single vessels, and then* 
 into- more and smaller, like the excretory vessels 
 of other glands. 
 
 Vasa deferentia are excretory ducts to carry the 
 elaborated seed into the vesiculse seminales. They 
 pass from the epididymi of the testicles, together 
 with the blood vessels, till they have entered the 
 muscles of the abdomen, and then they pass under 
 the peritonaeum, directly through the pelvis, to 
 the vesiculse seminales. 
 
 Vesicuke seminales are two bodies that appear 
 like vesicles ; they are seated under the bladder of 
 urine, near its neck ; they may be each of them 
 unfolded into one single duct, which discharges 
 into the urethra, by the sides of the rostrum gab 
 linaginis, which is an eminence in the under side 
 of the urethra near the neck of the bladder. In 
 these vesicles, or ducts, the seed is reposited 
 against the time of coition ; but in dogs there are 
 no such vesicles, therefore nature has contrived a 
 large bulb in their penis, which keeps them coup- 
 led, seemingly against their inclinations till the 
 seed can arrive from the testicles. The seed passes 
 from these vesicles in men, and even from the vasa 
 deferentia, in time of coition, through the prostate 
 glands into the urethra, as in those animals that 
 have no vesiculce seminales ; for when the ducts 
 into the urethra are distended, that is the direct 
 course from the vasa deferentia, as well from 
 the vesiculte seminales. 
 
PARTS OF MEN. 
 
 267 
 
 Prostats are two glands, or rather one, about 
 the size of a nutmeg : they lie between the 
 vesiculse seminales and penis, under the ossa pubis, 
 almost within, the pelvis of the abdomen. They 
 separate a limpid glutinous humour which is 
 carried into the urethra by several ducts, which en- 
 ter near those of the prostats. This iiquor seems 
 to be designed to be mixed with the seed in the 
 urethra, in the time of coition, to make it flow 
 more easily. If the venereal infection reaches the 
 prostate glands, it will sometimes make large ab- 
 scesses, which are apt to form sinuses, and even 
 make a passage into the bladder. Upon the first 
 attack of this disease, I have prevented all this 
 mischief, by taking off the external skin by in- 
 cision, as far as the hardness of the tumour ex- 
 tended, which draining very plentifully, the tumour 
 has subsided, and the patient been easily cured ; but 
 this case once becoming fistulous, is very difficult 
 indeed. It often is cured by opening the sinuses 
 and consuming the diseased parts by escarotics : but 
 a much better and easier way, which I have often 
 done, is to cut out all the fistulous and diseased parts 
 at once. 
 
 Penis ; its shape, situation, and use, need r.o 
 description. It begins with two bodies named 
 crura, from the ossa ischia, which unite under 
 the ossa pubis, and are there strongly connected 
 by a ligament. In its under part is the urethra, 
 through which both the seed and urine pass ; its 
 
268 
 
 URINARY AND GENITAL 
 
 fore part is called glans, the loose skin which cov- 
 ers it praeputium, and the straight part of that skin 
 on the under side, fraenum. The urethra is lined 
 with a membrane filled with small glands that 
 separate a mucus, that defends it against the acri- 
 mony of the urine. These glands are largest near- 
 est the bladder. Mr. Cowper. describes three large 
 glands of the urethra, which he discovered ; two 
 of which are seated on the sides of the urethra 
 near the ends of the crura penis ; to which he 
 adds a third, less than the other, seated almost in 
 the urethra, a little nearer the glans than the for- 
 mer. All these glands have excretory ducts into 
 the urethra, and from them are secreted all the 
 matter which flows from the urethra in a gonor- 
 rhcea, whether venereal or not. In the venereal 
 infection, the urethra and the glands are 'first in- 
 flamed by the contagious matter, that causes a heat 
 of urine, which abates as soon as the glands begin 
 to discharge freely $ but if by chance this disease 
 continues till any part of the urethra is ulcerated ; 
 the ulcer never heals without a cicatrix, which 
 constricts the urethra, and makes that disease 
 which is vulgarly called a caruncle. The inner 
 texture of the penis is spongy, like the inner tex- 
 ture of the spleen, or the ends of the great bones, 
 ft is usually distinguished into corpus cavernosum 
 penis, glandis, and urethrae. The first of these 
 makes part of the glans, and is divided its whole 
 length by a septuin $ the other two are composed 
 
FARTS OF MEW. 
 
 269 
 
 ■ 
 
 of smaller cells, and are but one body. On the 
 tipper side of the penis are two arteries, and one 
 vein called vena ipsius penis. The arteries are de- 
 rived from the beginnings of the umbilical arteries, 
 which parts never dry up, and the vein runs back 
 -to the iliac veins. The vena ipsius penis, being 
 obstructed, the blood that comes by the arteries, 
 distends the cells of the whole penis, and makes 
 it erect ; but to prevent mischief from this me- 
 chanism, there are small collateral veins on the sur- 
 face of the penis, that carry back some blood all 
 the time the penis is erect *, but by what power 
 the vena ipsius penis is obstructed to erect the 
 penis, I cannot conceive, unless small muscular 
 fibres constrict it. Some think the musculi erec- 
 tores penis do it, by thrusting the penis against 
 the os pubis ; but they seem not seated conve- 
 niently for such an office ; besides, if a pressure 
 from the lower side of the penis is sufficient, an 
 artificial pressure, which may be much greater, 
 should, I think, produce the same effect. 
 
 In the seed of men, and of other male animals, 
 Lewenhoeck, by the help of microscopes, dis- 
 covered an infinite number of animals like tad- 
 poles, which he and others suppose to be men in 
 miniature, and that one of these being entered 
 into an egg in one of the ovaria (see the next 
 chapter) conception is performed. But though 
 scarce any one, that has made due inquiry, has 
 ever doubted of -the existence of these animals. 
 
270 
 
 URINARY AND GENITAL 
 
 yet there are many who object against this hypoth- 
 esis ; and though I am inclined to think it true, 
 yet I will endeavour impartially to lay down the 
 principal objections and answers, that the reader 
 may judge for himself. The first and strongest 
 objection, is raised from the several instances that 
 have happened of mixed generation, where the 
 animal produced always appears to partake of both 
 kinds, as in the common case of a mule, which 
 is begot by an ass upon a mare ; when, according 
 to that hypothesis, they expect the animal pro- 
 duced frOm mixed generation should be entirely 
 of the same species with the male animal ; as the 
 seeds of plants, whatever earth they grow in, al- 
 ways produce plants of the same kind. Never- 
 theless, if we consider what influence women’s 
 fears or longings frequently have upon their chil- j 
 dren in utero, and how great a change castration | 
 makes in the shape of any animal, we cannot 
 then wonder if the mother’s blood, to which the ! 
 animal owes its nourishment and increase, from 
 the time of impregnation to the time of its birth, 
 should be thought a sufficient cause of resemblance i 
 between these animals and their mothers. Anoth- 
 er objection is, that nature should provide such 
 a multiplicity of these animals, when so few can . 
 ever be of use. To which it has been answered, 
 that in plants a very few of the whole that are 
 produced, fall into the earth, and produce plants ; j 
 and as in plants the greatest part of their seeds 
 
PARTS or he5t« 
 
 271 
 
 are the food of animals, so the greatest part of 
 the animalcule may as well live a time to enjoy 
 their own existence, as any other animal of as Iow- 
 an order. The last objection is their shape, which 
 I think will appear to have no great weight, 
 when we consider hove the eggs of flies produce 
 maggots, which grow up into flies ; and the tad- 
 pole produced from the egg of a frog, grows into 
 a form as different from a tadpole as the form of 
 a man : and if these animals had produced so few 
 at a time, as that their young might have under- 
 gone this change in utero, it is highly probable, 
 that we should not so much as have suspected these 
 analogous changes. But how the animal culse 
 themselves are produced, is a difficult question. 
 Tinless by equivocal generation, seeing none of 
 them appear to be in a state of increase, but all 
 of a size. 
 
 In a boy that died of the stone, I found a 
 double ureter, each part being dilated to an inch 
 diameter ; the pelvis in each kidney to twice its 
 natural bigness, and the tubuli urinarii, each as 
 large as the pelvis. 
 
 In a man that had never been cut for the stone, 
 I found the ureters dilated in some places to four 
 inches circumference, and in others but little dilat- 
 ed, and a stone that I found in the bladder was 
 less than a nutmeg, which must have fallen in sev- 
 eral pieces, or both ureters could not have been 
 dilated. From this, and other like observations^ 
 
272 genital parts Of WomenV 
 
 I think it appears, that the great size to which: 
 the ureters are usually extended, in people who 
 are troubled with the stone, is owing to small 
 stones which stick at the entrance into the blad- 
 der, until the obstructed urine, which dilates the 
 ureters, can force them into the bladder. 
 
 I have in several subjects found one kidney al- 
 most consumed, and once a man with but one kid-< 
 ney ; and I have seen lymphatics in a diseased 
 testicle, as large as a crow quill. 
 
 CHAPTER II. 
 
 Jf the genital parts Of women. 
 
 The external parts are the mons veneris, which' 
 is that rising of fat covered with hair above the 
 rima magna upon the os pubis, the great doub- 
 ling of the skin on each side the rima called labia, 
 and within these a lesser doubling named nymphae. 
 These help to close up the orifice of the vagi- 
 na. The nymphae are usually said to serve to de- 
 fend the labia from the urine ; but I do not see 
 how the labia stand more in need of such a de- 
 fence, than the nymphae themselves. 
 
 Clitoris is a small spongy body, bearing 
 some analogy to the penis in men, but has no 
 urethra. It begins with two crura from the ossa 
 ischia, which uniting under the ossa pubis, it 
 
GENITAL PARTS OF WOMEN, 273 
 
 proceeds to the upper part of the nymphte, where 
 it ends under a small doubling of skin, called prse» 
 putium ; and the end which is thus covered is call- 
 ed glans. This is said to be the chief seat of 
 pleasure in coition, in women, as the glans is in 
 men. 
 
 A little lower than this, just within the vagina, 
 is the exit of the meatus urinarius. 
 
 Vagina is seated between the bladder of urine 
 and the intestinum rectum. The texture of it 
 is membranous, and its orifice is contracted with 
 a sphincter (vid. muse, sphincter vaginae) but the 
 farther part is capacious enough to contain the pe- 
 nis without dilating. Near the beffinnin^ of the 
 vagina, immediately behind the orifice of the me- 
 atus urinarius, is constantly found in children a> 
 valve called hymen, which, looking towards the 
 orifice of the vagina, closes it ; but as children 
 grow up, and the sphincter vaginas grows strong 
 enough to contract and close the orifice of the 
 vagina, this valve becoming useless, ceases to in- 
 
 ! crease, and is then known by the name of carun- 
 culae myrtiformes. There have been a few instan- 
 ces in which the edges of this growing together, it 
 continued unperforate, until it has been necessary 
 to make an incision to let out the menses. The 
 inner part of the vagina is formed into rugae, 
 which are largest in those who have not used cop- 
 ulation 5 and least in those who have had many 
 children. Under these rugae are small glands, 
 
 m m 
 
2T4 GENITAL PARTS OT WOMEN. 
 
 whose excretory ducts are called lacunae : these 
 glands separate a mucilaginous matter to lubricate 
 the vagina, especially in coition : and are the seat 
 of a gonorrhoea in this sex, as the glands in the u- 
 rethra are in the male. 
 
 Uterus is seated at the end of the vagina ; it 
 is about one inch thick, two broad, and large, 
 enough to contain the kernel of a hazel nut ; but 
 th women that have had children, a little larger. 
 Its orifice into the vagina is called os tincae, from 
 the resemblance it bears to a tench’s mouth. It 
 has two round ligaments which go from the sides 
 of it to the groins through the oblique and trans- 
 verse muscles of the abdomen, in the same man- 
 ner as do the seminal vessels in men. This way 
 the gut passes in a hernia int'estinalis in women 
 (vid. musculi abdominis.) Some authors mention 
 ligamenta lata, which are nothing but a part of 
 the peritonxum. Near the sides of the uterus lie 
 two bodies called ovaria ; they are of a depressed 
 oval figure, about half the size of men’s testicles, 
 and have spermatic vessels ; they contain small pel- 
 lucid eggs, from which they have their name. 
 There are twO arteries and two veins, which pass 
 to and from the ovaries or testes, in the same 
 manner that they do in men ; but make more 
 windings, and the arteries dilate more suddenly, 
 in proportion as they are shorter. These arteries 
 and veins detach branches into the uterus and fal- 
 lopian tubes, and not only make communications' 
 
■GENITAL PARTS OF WOMEN. 
 
 275 
 
 ifeetwixt the artery and vein on one side and those 
 of the other, but also with the proper vessels of the 
 uterus, which are detached from the internal iliac 
 arteries and veins. From these vessels in the in- 
 side of the uterus, the menstrual purgations are 
 made in women, and something of the same kind 
 in brutes, as often as they desire coition. One use 
 of these purgations is, to open the vessels of the 
 uterus, for the vessels of the placenta to join to 
 them. Many authors have imagined, that there 
 must be some evacuations analogous to this, in 
 men, which I cannot see the necessity of ; but, 
 on the contrary, I believe that men’s not having 
 such evacuations, is the true reason why their bod- 
 ies grow larger and stronger than women’s : and 
 their continuing to grow longer before they are fit 
 for marriage, I also take to be the true reason why 
 there are more males born than females, in about 
 the proportion of thirteen to twelve ; for women 
 being sooner fit for marriage than men, fewer will 
 die before that time, than of men. 
 
 Near the sides of the ovaria are seated the tu- 
 bse fallopianx, one end of which is connected to the 
 uterus and the side of the ovarium by a mem- 
 brane, the other end is loose, and being jagged is 
 called morsus diaboli. Among these jags is a 
 small orifice which leads into the tube, which 
 near this end is about a quarter of an inch diame- 
 ter, and thence, growing gradually smaller, passes 
 to the uterus, and enters there with an orifice 
 
276 GENITAL PARTS OP WOMEN. 
 
 about the size of a hog’s bristle. The use of these 
 tubes is to convey the male seed from the uterus to 
 the ovaria, to impregnate the eggs for conceptions ; 
 yet they appear so ill adapted to this end, that 
 many have supposed there must be some other 
 passage from the uterus to the ovaria : but when 
 we consider the case of conceptions found in these 
 tubes, and the exact analogy between these and 
 the tubes of birds, where we have the most un- 
 deniable proofs of the seed going through the 
 tube, and of the eggs being impregnated that way, 
 and of the eggs coming from the ovarium through 
 the tube, and seemingly with much greater dif- 
 ficulty than in women ; and besides, how fre- 
 quently a matter like the male seed (which I sup- 
 pose is seed) is found in the fallopian tubes of 
 women, as I have found in executed bodies, and in 
 a common whore that died suddenly, it appears 
 to me almost certain, that the seed goes through 
 the fallopian tubes to the ovaria to impregnate 
 eggs, and comes back through the same tubes to 
 the uterus. I have seen in a woman both the fal- 
 lopian tubes unperforated, which, upon the fore- 
 going hypothesis, must have caused barrenness, 
 and seed lodged in these tubes may have the same 
 effect ; which I take to be often the case of com- 
 mon whores, and women that use coition too fre- 
 quently ; and perhaps the fat in the membrane 
 that connects the ovaria to the tubes, may in very 
 fat women so keep these tubes from the ovaria as 
 
GENITAL PARTS OF WOMEN. 
 
 277 
 
 to interrupt impregnations ; and besides these 
 cases, too much or too little of the menses may 
 destroy or interrupt conceptions ; but the latter 
 case, especially in young women, is very rare. 
 From such causes as these, and not from imbecil- 
 ity, I imagine it is that barrenness oftener pro- 
 ceeds from women than men ; and though women 
 do not propagate to so great an age as men, it is 
 not, I believe, for waat of being impregnated, 
 but from their menses ceasing, and those vessels 
 being closed which should nourish the foetus after 
 the impregnation, as if on purpose to prevent the 
 propagation of a feeble and infirm species. And 
 from this consideration, one cannot but think that 
 the perfection of the foetus, notwithstanding it is 
 first formed in the male seed, depends more upon 
 the female than the male ; or else that nature 
 would, for the sake of the species, have been careful 
 to hinder men as well as women from propagating 
 in a declining age. 
 
275 
 
 FOETUS IK UTERO. 
 
 CHAPTER III. 
 
 OF THE FOETUS IN UTERO. 
 
 The foetus in utero is involved in two coats, 
 viz. chorion, which is external, and amnion, which 
 immediately encloses the foetus. They contain a 
 quantity of liquor, which is a proper medium for 
 so tender a being as the foetus to rest in, and part- 
 ly secures it from external injuries, as the aqueous 
 humour does the crystalline in the eye \ and when 
 the membranes burst at the time of production, 
 this humour lubricates the vagina uteri, to ren- 
 der the birth less difficult. And seeing the stom- 
 ach of a foetus in utero is always full of a fluid, 
 like what is contained in the amnion, and the 
 guts not without excrements ; we may suppose 
 that this fluid is frequently, during the time of 
 gestation, swallowed by the foetus, if not for nour- 
 ishment, at least to keep these parts in use, and to 
 flow through the lacteals, as a quantity of blood 
 from the right ventricle of the heart flows through 
 the lungs before the birth to keep open those pas- 
 sages till the birth, there being after that time no 
 other way of receiving nourishment, and that the 
 faeces found in the guts of a foetus are those parts 
 of this fluid that were taken in at the mouth, 
 and were too gross to enter the lacteals. Yet I 
 own it takes off very much from the probabil- 
 ity of the opinion of the foetus’s imbibing this 
 
TOETUS IN UTERO. 
 
 279 
 
 liquor, that, if I am rightly informed, some who 
 have been born with mouths and nostrils unper- 
 forate, have had such fluids and excrements in the 
 intestines that other foetus’s have, which must be 
 confessed, may be derived from the salivary glands' 
 and from the liver, &c. The following curious 
 passage was sent me by Mr. Monro. “ This li- 
 44 quor contributes nothing to the nourishment of 
 44 the foetus, for these reasons ; first, because, as 
 44 you have well observed, vast numbers of in- 
 44 stances might be produced, where no passage 
 44 w’as to be found for it : I shall give you one I 
 44 saw myself in the Hotel de Dieu at Paris, in 
 4r 1718. 
 
 44 Mary Guerlin brought forth two children, 
 44 one a complete girl, the other had neither head, 
 44 neck, arms, heart, lungs, stomach, small guts,- 
 44 liver, spleen, or pancreas, yet the great guts, 
 44 the organs of urine and generation of a female, 
 44 and lower extremities were perfect, and of a na- 
 44 tural growth ; the umbilical vein, after entering 
 44 the abdomen, split into a great many branches, 
 44 which were distributed to the several parts in 
 44 its abdomen. Though it is true that soon af- 
 44 ter conception, the liquor in the amnion, and 
 44 that in the stomach of the foetus resemble one 
 44 another pretty near, yet afterward they differ 
 44 exceedingly ; for the liquor in the stomach is 
 44 still gelatinous, thick, and without acrimony, 
 44 while the other becomes thinner and more acrid ;■ 
 
280 
 
 foetus in utero. 
 
 <e whereas, had the foetus constantly swallowed 
 4C this liquor, the case would have been quite op- 
 “ posite ; nay, often it has happened that these 
 <c waters (as they are commonly called) have been 
 “ found quite corrupted, strongly fetid, and ex- 
 44 tremely sharp, while the foetus, except the in- 
 44 juries which the external parts received, was 
 44 well and sound ; witness the example mentioned 
 “ by Bellinger, of a woman who was cured of 
 44 a virulent gonorrhoea during her going with 
 44 child. And farther, by Malpighius’s delinea- 
 44 tions of the pullus in ovo, it appears to be evi- 
 44 dent that the asitellus serves the same purpose as 
 44 the placenta does in viviparous animals, to con- 
 44 vey the albumen attenuated by incubation into 
 44 the blood vessels of the chick, and that none of 
 44 the albumen does pass through the saccus colli- 
 54 quamentid’ 
 
 Besides these coats, in a cow and many other ani- 
 mals, we find a membrane called alantois ; it is en- 
 closed by the chorion together with the amnion, 
 and contains a quantity of water which it receives 
 from the bladder of urine by the urachus. Its use 
 seems to be to contain the urine, that it might not 
 by the common passage be emptied into the liquor 
 of the amnion, of which the foetus, I am inclined to 
 think, is frequently drinking. 
 
 Whether an alantois is to be found with a hu- 
 man fetus or no, anatomists are not agreed, and 
 I cannot give my opinion, having never had a 
 
281 
 
 FOETUS IN UTERO. 
 
 sufficient opportunity to inquire. But surely chil- 
 dren having an urachus, one cannot well doubt of 
 an alantois. I have been informed by a gentleman, 
 who-se probity I can sufficiently rely on, that he 
 had seen a child that had no external genital parts, 
 and made water through the navel. At Henley 
 upon Thames, there is now living a bargeman’s 
 child about ten years old, of which I had the like 
 account ; but upon examination I found the un- 
 perforated glans with its fraenum immediately be- 
 low the place of the navel, and the urine issued 
 out by drops between this and the belly, in the 
 place which I suppose was the navel, but it was 
 so much excoriated, that I could make no certain 
 judgment about it. In the uterus of a cow with 
 two calves, I found they had but one chorion, 
 but each an amnion and alantois distinct ; but the 
 cotyledons, which are analogous to the placenta of 
 the human foetus, were pretty much in common to 
 the umbilical blood vessels of both. 
 
 The placenta, or womb-liver, is a mass of 
 blood vessels seated on the outside of the chorion, 
 being composed of the extreme branches of the 
 umbilical vein and arteries, which are, for the 
 composition of this part, divided into exceeding 
 small branches, to join a like number of the men- 
 strual vessels of the uterus ; which vessels of the 
 uterus are made numerous rather than large, that 
 the separation of the placenta from them may not 
 be attended with a flux of blood fatal to the mo- 
 
 n n 
 
2&2 lO'ETUS IN UTEftO» 
 
 ther ; for the sides of little vessels soon collapse 
 and dose, and they are more easily stopped, being 
 compressed by the uterus itself as it shrinks, which 
 it begins to do from the time of the birth ; but 
 when the placenta is separated before the delivery, 
 whether untimely or not, these vessels bleed until 
 the uterus is discharged of the foetus. The figure 
 of the placenta is circular, and at its greatest 
 growth about two inches thick, and six or seven 
 in diameter. 
 
 The arteries and veins of the uterus of the mo^ 
 ther, by which the menstrual purgations are made*- 
 are joined to the umbilical arteries and veins in the 
 placenta of the foetus, the arteries of the uterus ta 
 the veins in the placenta, and the veins in the 
 uterus to the arteries of the placenta : by these 
 vessels a large quantity of blood is continually 
 ilowing from the mother to the foetus and back 
 again ; but for what end such a quantity flows 
 continually, and back again, I cannot conceive* 
 Unless it is that the foetus not breathing for itself, 
 it is necessary that as much blood of the mother 
 should flow continually to the foetus, as can leave 
 enough of air, or whatever our blood receives in 
 the lungs, for the foetus ; and perhaps what nutri- 
 tious juices the foetus receives, require a great deal 
 of olood to convey them, they being but a small 
 part of the blood. And though the blood passes- 
 so plentifully between the mother and the foetus, 
 yet the communications are not so obvious as they 
 
FOETUS IN UTERO. 233 
 
 mtt between the arteries and veins in the same 
 body ; which makes some think the communica- 
 tion is not made by inosculations of vessels, but that 
 the foetus is nourished from the placenta in a vege- 
 table manner ; but, I own, I am not of this opin- 
 ion. The navel string or umbilical blood vessels, 
 between the placenta and the navel, are about two 
 feet long, that the foetus may have room to move 
 without tearing the placenta from the uterus, 
 which being done too soon, from whatever cause, 
 occasions a miscarriage. These vessels, viz. two 
 arteries and one vein, twist about each other, par- 
 ticularly the arteries about the vein, and are con- 
 tained in one common coat together with a vessel 
 called urachus, which arises from the top of the 
 bladder of urine, and ends in the membrana alan- 
 tois ; the umbilical vein goes from the navel di- 
 rectly into the liver, and there enters the great 
 trunk of the vena portae. Near which entrance 
 there goes out the ductus venosus to the great 
 trunk of the cava, which carries part of the blood 
 that is brought by the umbilical vein, that way 
 into the cava, while the rest circulates with the 
 blood in the porta, the whole of it not passing 
 through the ductus venosus, as is generally believed, 
 but a great part of it into branches of the porta, 
 in the liver, otherwise there need be no commu- 
 nication between the umbilical vein and the porta. 
 When the umbilical vein is stopped, it becomes 
 a ligament, and the ductus venosus soon shrinks 
 
284 FOETUS IN UTER©. 
 
 and almost disappears, having no longer any blood 
 flowing through it ; and even the porta itself 
 within the liver, from whence only blood could 
 pass after the birth into the ductus venosus, has 
 less blood flowing through it for some time than 
 it had before the birth, it receiving much blood 
 before the birth from the umbilical vein. The 
 blood which flows from the mother to the foetus 
 by the umbilical vein, is returned, all but a small 
 quantity, which is reserved for nutrition by the 
 two umbilical arteries, which arise from the inter- 
 nal iliac arteries, and passing by the outsides of 
 the bladder go directly to the navel, and placen- 
 ta ; these with the urachus being shrunk up after 
 the birth, lose much of their appearance, especially 
 near the navel, where they are sometimes not to 
 be distinguished. 
 
 Part of the blood before the birth, and not the 
 whole quantity, as is generally thought, which is 
 brought by the ascending cava to the right auri- 
 cle, passes at once through the foramen ovale into 
 the left auricle, and the rest flows into the right 
 ventricle with the blood of the descending cava, 
 and thence into the pulmonary artery, where about 
 one half flows into the lungs, and the other half 
 directly into the aorta by the ductus arteriosus, 
 which lies between the pulmonary artery and the 
 aorta, which after the birth is called ductus ar- 
 teriosus in ligamentum versus. The better to ex- 
 plain this contrivance, I wall call the quantity of 
 
TOETUS IN UTERO. 
 
 285 
 
 blood flowing through the ascending cava in a 
 given time, four ; and that which flows through 
 the descending cava, two : then let two of the 
 quantity in the ascending cava flow into the right 
 auricle, it will then with the two received from 
 the descending cava have the quantity four ; which 
 being thrown from the right ventricle into the 
 pulmonary artery, the quantity two is thrown into 
 the aorta by the ductus arteriosus, and the same 
 quantity into the lungs by the pulmonary branches ; 
 then the quantity returning from the lungs to 
 the left auricle, will be two in the same given 
 time, which being added to the two which flowed 
 through the foramen ovale, in the same time 
 there will be constantly the same proportions re- 
 ceived into each ventricle, at every diastole of the 
 ventricles, as after the birth. Now if the blood, 
 flowing through the ascending cava joined by that 
 from the umbilical vein, was but equal to that 
 flowing through the descending, let each of them 
 be called two, and let all the blood of the ascend- 
 ing cava go through the foramen ovale ; then the 
 blood which the left ventricle would receive, 
 would exceed that which flows into the right, by 
 the whole quantity which flows from the lungs 
 in the same time ; but the ascending cava convey- 
 ing more blood than the descending cava, the ex- 
 cess in the left ventricle would be yet greater. If 
 the proportions, which I have taken for the easier 
 computing, were perfectly right, as I am sure 
 
286 
 
 FOETUS IN uteao. 
 
 they are nearly, then the quantity flowing into the 
 left ventricle would be to that flowing into the 
 right at the same time as five to two, if all the as- 
 cending blood went through the foramen ovale* 
 
 And though after the birth the left ventricle of 
 the heart is Only employed in throwing blood into 
 the aorta, and the right wholly employed in cir- 
 culating the blood through the lungs ; yet before 
 the birth, all the blood thrown out by the left ven- 
 tricle, and about half the blood thrown out of 
 the right ventricle, being thrown into the aorta, 
 and the other part only through the lungs, it fol- 
 lows, that the whole force exerted by the left 
 ventricle, with about half that of the tight, is 
 employed in throwing blood into the aorta, while 
 that distributes blood through the whole foetus 
 and to the mother : but after the birth, when the 
 blood is to be no longer carried from the foetus 
 to the mother, the left ventricle becomes sufficient 
 for the circulation through the foetus, and a new 
 occasion immediately arises for that additional 
 power, which before was necessarily employed 
 in throwing blood into the aorta : for the whole 
 mass of blood now being to be circulated through 
 the lungs, the ductus arteriosus closes, and the 
 right ventricle must throw all the blood it receives 
 into the lungs, there being no longer any passage 
 into the aorta. It is supposed that the inflation of 
 the lungs at the birth, presently alters the position 
 of the ductus arteriosus, so as to obstruct it ; which 
 
rOETtJS IN UTERCe 28 1 
 
 account is indeed mechanical, but, I think, not 
 true, because I can neither discern that the position 
 of this vessel is. altered, nor its surface compressed : 
 but I rather think that immediately upon the 
 birth, there beino- no blood carried off from the 
 foetus to the mother, and the left ventricle being 
 sufficient to fill the aorta and its branches with 
 blood, as I have shewn before, there is no longer 
 room for any blood from the right ventricle ; 
 wherefore the blood from the right ventricle will 
 be forced into the lungs, where the passage is 
 now made easy, as I imagine, by their being in- 
 flated ; and the ductus arteriosus, having the blood 
 no longer forced into it, shrinks, and in time al- 
 most disappears. This duct being stopped, the 
 valve of the foramen ovale soon stops that passage, 
 it being on the side of the left auricle (or that 
 muscular bag, which is the largest part of that 
 auricle) which being much the strongest, the valve 
 must be pressed more on that side than the other, 
 by the blood, in the time of the systole of the au- 
 ricle ; and it is as evident, that in the diastole of 
 the auricle, there must be more pressure to open 
 that than the right, it being a stronger muscle, or 
 else there could have been no reason for having 
 the left auricle stronger than the right, in propor- 
 tion to their ventricles. Sometimes this valve does 
 not quite cover the foramen, in which case a small 
 quantity of the blood may possibly Sow from the 
 left auricle to the right, and so circulate twice 
 
288 
 
 FOETUS IN UTERO. 
 
 through the lungs to once through the body, blit 
 none could flow from the right to the left and 
 escape the lungs, which might be of bad conse- 
 quence. Some have imagined, that men, who 
 have this passage open, cannot be drowned : but 
 though this passage is sometimes found open, no 
 man has been yet seen, that we have ever heard of, 
 that could not be drowned. I have seen the fo- 
 ramen open in a man that was hanged, to whom 
 one might justly expect it should have been as use- 
 ful as An the case of submersion in water. Many 
 writers have supposed, that this foramen is open in 
 amphibious animals, and in such fishes as have 
 two auricles, two ventricles, and lungs like land 
 animals, without gills, which in other fish are 
 analogous to lungs. I have dissected a porpoise, 
 which is of this kind, and found this foramen 
 closed, but the great veins were vastly large in pro- 
 portion to the bulk of the animal ; whence I con- 
 jectured, their blood was accumulated in their 
 veins, while they kept under water, and by that 
 means the lungs escaped being oppressed with 
 blood ; which conjecture seemed to me the more 
 probable, since all animals of this kind are able to 
 abide the least time under water, when their blood 
 is most expanded with heat. But upon the dis- 
 section of an otter, whose foramen ovale was also 
 closed, I found the veins nothing differing from 
 those of other animals. In a water tortoise, which 
 I had an opportunity of examining, with that 
 
FOETUS IN UTERO. 289 
 
 most dexterous and indefatigable anatomist, Dr. 
 Douglas, I found the two ventricles of the 
 heart but half divided by a septum, and in the 
 beginning of the pulmonary artery several strong 
 muscular rings, a little distance from each other, 
 each of which, by contracting, would be capable 
 of resisting a part of that blood which otherwise 
 would have been thrown into the lungs, when 
 they were under water ; and this blood so ob- 
 structed must necessarily be thrown into the aorta, 
 the two ventricles being; in a manner one com- 
 mon cavity ; and when they are out of the water, 
 this communication of ventricles, will suffer but 
 little confusion of the blood which flows into the 
 ventricles, because each ventricle receiving and 
 discharging the same quantity of blood, at the same 
 time, they will balance each other, and thereby such 
 a mixture will be very much prevented. Mr. 
 Monro observes, that the water tortoise has very 
 large lungs, consisting of larger vesicles than land 
 animals, and that they receive a great quantity of 
 air to furnish that je ne S9ai quoi so necessary for 
 the life of animals ; the same thing I have observed 
 in frogs. 
 
 As to the reason of women’s bringing forth at 
 the usual time ; it has been said, that at that time 
 the head of the child begins to be specifically heav- 
 ier than the rest of the body, and therefore must 
 fall lowest in the fluid it lies in, which being an 
 uneasy posture, makes the child struggle, and 
 
 o o 
 
290 
 
 OF THE EYE* 
 
 bring on the labour. But it is not true, that the 
 head then alters its specific gravity ; or, if it did, 
 there is seldom fluid enough in the amnion for this 
 purpose ; and besides, this could only happen right 
 in one posture, and would usually happen wrong 
 in brutes. 
 
 CHAPTER IV. 
 
 OF THE EYE. 
 
 1 HE figure, situation, and use of the eyes, 
 together with the eyebrows, eyelashes, and eye- 
 lids, being well known, I need only describe 
 what is usually shewn by dissecting. The orbit 
 of the eye, or cavity in which it is contained, 
 is in all the vacant places filled with a loose fat, 
 which is a proper medium for the eye to rest in, 
 and serves as a socket for it to be moved in. In 
 the upper and outer part of the orbit, is seated the 
 lacrymal gland. Its use is to furnish at all times 
 water enough to wash off dust, and to keep the 
 outer surface of the eye moist, without which 
 the tunica cornea would be less pellucid, and the 
 rays of light would be disturbed in their passage ; 
 and that this liquor may be rightly disposed of, we 
 frequently close the eyelids to spread it equally, 
 even when we are not conscious of doing it. At 
 the inner corner of the eye, between the eyelids. 
 
OF THE EYE. 
 
 291 
 
 stands a caruncle, which seems to be placed to 
 keep that corner of the eyelids from being totally 
 closed, that any tears or gummy matter may flow 
 from under the eyelids, when we sleep, or into 
 the puncta lacrymalia, which are little holes, one 
 in each eyelid, near this corner, to carry off into 
 the ductus ad nasum any superfluous tears. 
 
 The first membrane of the eye is called con- 
 junctiva ; it covers so much of the eye as is called 
 the white, and being reflected all round, it lines 
 the two eyelids ; it being thus returned from the 
 eye to the inside of the eyelids, it effectually hin- 
 ders any extraneous bodies from getting behind the 
 eye into the orbit, and smooths the parts it cov- 
 ers, which makes the friction less between the eye 
 and the eyelids. This coat is very full of blood 
 vessels, as appears upon any inflammation. 
 
 Tunica sclerotis, and cornea, make together 
 one firm case of a proper form, for the use 
 of the other coats and humours. The fore part 
 of this strong coat being transparent, and like 
 horn, is called cornea, and the rest sclerotis. Un- 
 der the cornea lies the iris, which is an opaque 
 membrane, like the tunica choroides, but of dif- 
 ferent colours in different eyes, such as the eye 
 appears, as grey, black, or hazel ; for being seat- 
 ed under the tunica cornea, it gives such an ap- 
 pearance to that as it has itself. The middle of 
 it is perforated for the admission of the rays of 
 light, and is called the pupil. Immediately under 
 
292 
 
 OF THE EYE. 
 
 the iris lie the processus ciliares, like radial lines 
 from a lesser circle to a greater. When these pro- 
 cesses contract, they dilate the pupil to suffer more 
 rays of light to enter into the eye ; and the con- 
 trary is done by the circular fibres of the iris, 
 which act as a sphincter muscle : but these changes 
 are not made with great quickness, as appears from 
 the eyes being oppressed with a strong light for 
 some time, after we come out of a dark place, 
 and from the contrary effect in going suddenly 
 from a light place to a dark one. And as the pu- 
 pil always dilates in darker places, to receive more 
 rays of light, so when any disease makes some of 
 those rays ineffectual, which pass through the 
 pupil, it dilates as in dark places to admit more 
 light ; therefore a dilated pupil is a certain sign of 
 a bad eye, and this may be discerned usually sooner 
 than the patient discerns any defect in vision. In 
 men the pupil is round, which fits them to see 
 every way alike : it is also round in animals that 
 are the prey both of birds and beasts. But gra- 
 minivorous brutes, that are too large to be the prey 
 of birds, have it oblong horizontally, which fits 
 them to view a large space upon the earth ; while 
 animals of the cat kind, who climb trees and prey 
 indifferently on birds or animals that hide in the 
 earth, have their pupils oblong the contrary way, 
 which fits them best to look upward and down- 
 ward at once. Besides these there are other anh 
 mals whose pupils are in these forms, but in less 
 
OF THE EYE. 
 
 293 
 
 proportions, so as best to fit their ways of life. 
 Immediately under the sclerotis, is a membrane of 
 little firmness, called choroides. In men it is of 
 a rusty dark colour, such as will bury almost all 
 the rays of light, that pass through the tunica 
 retina, which if it were of a brighter colour, 
 would reflect many of the rays upon the x*etina, 
 and make a second image upon the first somewhat 
 less, and less distinct, but both together stronger ; 
 which is the case of brutes of prey, where a great 
 part of this coat is perfectly white, which makes 
 them see bodies of all colours in the night better 
 than men, for white reflects all colours : but 
 brutes that feed only on grass, have the same parts 
 of this membrane of a bright green, which enables 
 them also to see with less light, and makes grass 
 an object that they can discern with greatest 
 strength. But these advantages in brutes necessa- 
 rily destroy great accuracy in vision, which is of 
 little or no use to them, but to men of great conse- 
 quence. This green part of the tunica choroides 
 in animals that graze, may properly be called mem- 
 brana uvea, from its resemblance in colour to an 
 unripe grape. But in men’s eyes only a white 
 circle round the back side of the choroides near the 
 cornea, is called uvea. 
 
 Immediately under the tunica choroides 
 lies the tunica retina, which is the optic nerve 
 expanded and coextended with the choroides. 
 Rays of light striking upon this membrane, the 
 
294 
 
 OF THE EYE. 
 
 sensation is conveyed by the optic nerves, to the 
 common sensorium the brain. These nerves do not 
 enter at the middle of the bottom of the eyes, 
 but nearer the nose ; for those rays of light being 
 ineffectual for vision that fall upon the entrance of 
 the optic nerves, it is fit they should so enter, as 
 that the same object or part of any object should 
 not be unperceived in both eyes, as would have 
 been the case, had they been otherwise inserted ; 
 which appears from a common experiment of part 
 of an object being lost to one eye, when we are 
 looking towards it with the other shut. I know 
 a gentleman, who having lost one eye by the small- 
 pox, and going through a hedge, a thorn unseen 
 (probably from this cause) struck the other and 
 put it out. The two optic nerves, soon after they 
 arise out of the brain, join, and seem perfectly 
 united ; yet from the following case I am not 
 without suspicion of their fibres being preserved 
 distinct, and that the nerve of each eye arises 
 wholly from the opposite side of the brain, or 
 else that the other nerves throughout the body arise 
 from the brain, and medulla oblongata, on the 
 sides opposite to those they come out of. A sol- 
 dier, who was my patient in the hospital about 
 five years since, had, by a push with a broad 
 sword, his left eye raised in the orbit, which I 
 replaced with my fingers ; it was presently follow- 
 ed with excessive pain in the right side of the 
 head only ; and a loss of the sense of feeling and 
 
OF THE EYE. 
 
 295 
 
 motion in both the right limbs ; the sense of feel- 
 ing he recovered by degrees in about a month, and 
 soon after began to recover their motion, but was 
 twelve months before he could walk, and lift up 
 his hand to his head ; and in about two years re- 
 covered all but the sight of the wounded eye, 
 which indeed did not appear perfect. In fish 
 these nerves arise distinct from the opposite sides 
 of the brain, and cross without uniting ; but as 
 these animals have their eyes so placed, as not to 
 see the same object with both eyes at once, where- 
 as animals, whose optic nerves seem to unite, do 
 see the same object with both eyes at once, one 
 would suspect that in one they were joined to 
 make the object not appear double, and in the 
 other distinct, to make their two eyes (as they are 
 to view different objects at the same time) inde- 
 pendent on each other : and yet from the follow- 
 ing cases, the seeing objects single seems not to 
 depend upon any such union, nor from the light 
 striking upon corresponding fibres of the nerves, 
 as others have believed, but upon a judgment from 
 experience, all objects appearing single to both 
 eyes in the manner we are most used to observe 
 them, but in other cases double ; for though we 
 have a distinct image from each eye sent to the 
 brain, yet while both these images are of an ob- 
 ject seen in one and the same place, we conceive 
 of them as one ; so when one image appears to 
 the eyes (when they are distorted or wrong di- 
 
296 
 
 OF THE EYE. 
 
 rected) in two different places, it gives the idea of 
 two ; and when two bodies are seen in one plac6, 
 as two candles rightly placed, through one hole 
 in a board, they appear one. But cases of this 
 kind being too numerous, I will conclude with 
 one very remarkable, and, I think, much in favour 
 of this opinion. A gentleman, who from a blow 
 on the head had one eye distorted, found every 
 object appear double, but by degrees, the most fa- 
 miliar ones became single, and in time, all objects 
 became so, without any amendment of the distor- 
 tion. 
 
 The inside of the eye is filled with three hu- 
 mours, called aqueous, crystalline, and vitreous. 
 The aqueous lies foremost, and seems chiefly of 
 use to prevent the crystalline from being easily 
 bruised by rubbing, or a blow ; and perhaps it 
 serves for the crystalline humour to move forward 
 in, while we view near objects, and backward for 
 remoter objects ; without which mechanism, or, 
 in the place of it, a greater convexity in the crystal- 
 line humour in the former case, and a less con- 
 vexity in the latter, I do not imagine, according 
 to the laws of optics, how we could so distinctly see 
 objects at different distances. However it is in 
 land animals, I think we may plainly see that 
 fish move their crystalline humour nearer the bot- 
 tom of the eye when they are out of water, and 
 the contrary way in water ; because light is less 
 refracted from water through the crystalline hu- 
 
OF THE EYE. 
 
 297 
 
 momr than from air. Some have said, that am- 
 phibious animals have a membrane like the mem- 
 brana nictitans of birds, which serves them as a 
 lens in the water. I have examined the eye of a 
 crocodile, which Sir Hans Sloan kept in spir- 
 its, and I found this membrane equally thick 
 and dense, and consequently unfit for this pur- 
 pose, or, I believe, any other, except that obvious 
 one, of defending the eye from the water. Next 
 behind the aqueous humour lies the crystalline ; its 
 shape is a depressed spheroid, it is distinctly con- 
 tained in a very fine membrane called aranea. 
 The use of this humour is to refract the rays of 
 light which pass through it, so that each pencil of 
 rays from the same point of any object may be 
 united upon the retina, as in a camera obscura, 
 to make the stronger impression : and though by 
 this union of the rays a picture inverted is made 
 upon the retina, yet surely it is the impulse only 
 of the rays upon the retina that is the cause of 
 vision ; for had the colour of the retina been black, 
 and consequently unfit to receive such a picture, 
 would not the impulse of light upon it have been 
 sufficient for vision ? or would such a picture, if 
 it could have been made without any impulse, 
 have ever conveyed any sensation to the brain ? 
 Then if the impulse of light upon the retina, and 
 not the image upon the retina, is the cause of vi- 
 sion ; when we inquire why an image inverted in 
 the eye appears otherwise to the mind, might 
 
 p P 
 
29a 
 
 OF THE EYE. 
 
 we not expect to find the true cause from consul^ 
 ering the directions in which the rays strike the 
 retina, as we judge of above and below from a. 
 like experience, when any thing strikes upon any 
 part of our bodies ? Nevertheless, in viewing an 
 object through a lens, we conceive of it as in- 
 verted ; when as in receiving the impulses of light 
 in the same manner, and having the picture on 
 the retina in the same attitude, when we stand 
 on our heads without the lens, we have not 
 the same, but the contrary idea of the position of 
 the object. Though I have considered this hu- 
 mour only as a refractor of light, yet the first and 
 greatest refraction is undoubtedly made in the cor- 
 nea ; but it being concavo-convex, like glasses of 
 that kind, while one side makes the rays of light 
 converge, the other diverges them again. The 
 same thing also may be observed of the aqueous 
 humour, which is indeed more concave than con- 
 vex ; but when the crystalline humour is removed 
 in the couching a cataract, the aqueous possesses its 
 place and becomes a lens ; but that refracting light 
 less than the crystalline, whose place and shape it 
 partly takes, the patient needs a convex glass to 
 see accurately. In some eyes, either this humour 
 heine;; too convex or too distant from the retina, 
 the rays unite too soon, unless the object is held 
 very near to the eye, which fault is remediable 
 by a concave glass ; as the contrary fault, common 
 to old persons, is by a convex glass. If the eye. 
 
OF THE EYE. 
 
 299 
 
 liad been formed for a nearer view, the object 
 would often obstruct the light ; if it had been 
 much farther, light enough would not commonly 
 have been produced from the object to the eye. 
 In fish the crystalline humour seems a perfect 
 sphere, which is necessary for them, because light 
 being less refracted from water through the crys- 
 talline humour than from air, that defect is com- 
 pensated by a more convex lens. The vitreous 
 humour lies behind the crystalline, and fills up the 
 greatest part of the eye : its fore side is concave 
 for the crystalline humour to lodge in, and its 
 back side being convex, the tunica retina is spread 
 over it ; it serves as a medium to keep the crystal- 
 line humour and the retina at a due distance. 
 
 The larger animals having larger eyes, their 
 organs of vision, like a microscope with a large 
 lens, are fit to take in a greater view, but in that 
 view things are not so much magnified ; in lesser 
 animals a small space is discerned, such as is their 
 sphere of action, but that greatly magnified, not 
 really so in either case, but comparatively, for 
 vision shews not the real magnitude of objects, 
 but their proportions one to another. Fish have 
 their eyes, and particularly their pupils, larger 
 than land animals, because there is less light, and 
 that not so far distributed in water as in the air. 
 In all inflammations in the eye, the utmost haste 
 should be made, by bleeding, purging, abstinence, 
 &c. to get rid of the inflammation, because a con- 
 
500 OF THE EYE. 
 
 tinued inflammation seldom fails to make white 
 opaque scars in the cornea, which cause dimness 
 if not blindness ; and no eye water with powders 
 in it should ever be put upon the eye, because none 
 can be made fine enough. 
 
 An account of observations made by a young gentle- 
 man who was born blind , or lost his sight so early 
 that he had no remembrance of ever having seen , 
 and was couched between thirteen and fourteen years 
 of age. 
 
 THOUGH we say of this gentleman that he 
 was blind, as we do of all people who have ripe 
 cataracts, yet they are never so blind from that 
 cause but that they can discern day from night, 
 and for the most part, in a strong light, distinguish 
 black, white, and scarlet ; but they cannot per- 
 ceive the shape of any thing ; for the light, by 
 which these perceptions are made, being let in ob- 
 liquely through the aqueous humour, or the ante- 
 rior surface of the crystalline, by which the rays 
 cannot be brought into a focus upon the retina, 
 they can discern in no other manner, than a sound 
 eye can through a glass of broken jelly, where a 
 great variety of surfaces so differently refract the 
 light, that the several distinct pencils of rays can- 
 not be collected by the eye into their proper foci ; 
 wherefore the shape of an object in such a case 
 cannot be at all discerned, though the colour may j 
 
OF THE EYE. 
 
 301 
 
 And thus it was with this young gentleman, who, 
 though he knew these colours asunder in a good 
 light, yet when he saw them after he was 
 couched, the faint ideas he had of them before, 
 were not sufficient for him to know them by after- 
 wards, and therefore he did not think them the 
 same which he had before known by those names. 
 Now scarlet he thought the most beautiful of all 
 colours, and of others the most gay were the most 
 pleasing ; whereas the first time he saw black it 
 gave him great uneasiness, yet after a little time he 
 was reconciled to it ; but some months after, see- 
 ing by accident a negro woman, he was struck 
 with great horror at the sight. 
 
 When he first saw, he was so far from mak- 
 ing any judgment about distances, that he thought 
 all objects whatever touched his eyes (as he ex- 
 pressed it) as what he felt did his skin, and thought 
 no object so agreeable as those which were smooth 
 and regular, though he could form no judgment 
 of their shape, or guess what it was in any object 
 that was pleasing to him : he knew not the shape 
 of any thing, nor any one thing from another, 
 however different in shape or magnitude : but 
 upon being told what things were, whose form 
 he before knew from feeling, he would carefully 
 observe, that he might know them again ; but 
 having too many objects to learn at once, he for- 
 got many of them ; and (as he said) at first he 
 learned to know, and again forgot a thousand 
 
502 
 
 or THE EYE. 
 
 •things in a day. One particular only, though it 
 may appear trifling, I will relate : Having often 
 forgot which was the cat, and which the dog, he 
 was ashamed to ask 5 but catching the cat, which 
 he knew by feeling, he was observed to look at 
 her steadfastly, and then, setting her down, said, 
 So, puss, I shall know you another time. He was 
 very much surprised, that those things which he 
 had liked best, did not appear most agreeable to 
 his eyes, expecting those persons would appear 
 most beautiful that he loved most, and such things 
 to be most agreeable to his sight that were so to 
 his taste. We thought he soon knew what pic- 
 tures represented, which were shewed to him, 
 but we found afterwards we were mistaken ; for 
 about two months after he was couched, he dis- 
 covered at once they represented solid bodies, 
 when to that time he considered them only as 
 party coloured planes, or surfaces diversified with 
 variety of paint ; but even then he was no less 
 surprised, expecting the pictures would feel like 
 the things they represented, and was amazed 
 when he found those parts, which by their light 
 and shadow appeared now round and uneven, felt 
 only flat like the rest, and asked which was the ly- 
 ing sense, feeling, or seeing ? 
 
 Being shewn his father’s picture in a locket 
 at his mother’s watch, and told what it was, he 
 acknowledged a likeness, but was vastly surprised ; 
 asking how it could be, that a large face could 
 
SF THE E7E. 
 
 303 
 
 be expressed in so little room ; saying, it should 
 have seemed as impossible to him, as to put a 
 bushel of any thing into a pint. 
 
 At first, he could bear but very little light, and 
 the things he saw he thought extremely large 5 
 but upon seeing things larger, those first seen he 
 conceived less, never being able to imagine any 
 lines beyond the bounds he saw ; the room he 
 was in, he said, he knew to be but part of the 
 house, yet he could not conceive that the whole 
 house could look bigger. Before he was couched, 
 he expected little advantage from seeing, worth 
 undergoing an operation for, except reading and 
 writing ; for he said, he thought he could have 
 no more pleasure in walking abroad than he had 
 in the garden, which he could do safely and read- 
 ily. And even blindness, he observed, had this 
 advantage, that he could go any where in the dark, 
 much better than those who can see ; and after 
 he had seen, he did not soon lose this quality, nor 
 desire a light to go about the house in the night. 
 He said, every new object was a new delight ; and 
 the pleasure was so great, that he wanted words to 
 express it ; but his gratitude to his operator he 
 could not conceal, never seeing him for some time 
 without tears of joy in his eyes, and other marks of 
 affection : and if he did not happen to come 
 at any time when he was expected, he would be 
 so grieved, that he could not forbear crying at his 
 disappointment. A year after first seeing, being 
 
304 
 
 OF THE EAR. 
 
 carried upon Epsom Downs, and observing a large 
 prospect, he was exceedingly delighted with it, 
 and called it a new ldnd of seeing - . And now 
 
 o 
 
 * being lately couched of his other eye, he says, 
 that objects at first appeared large to this eye, but 
 not so large as they did at first to the other ; and 
 looking upon the same object with both eyes, he 
 thought it looked about twice as large as with 
 the first couched eye only, but not double, that 
 we can any ways discover. 
 
 I have couched several others who were born 
 blind, whose observations were of the same kind ; 
 but they being younger, none of them gave so 
 full an account as this gentleman. 
 
 CHAPTER V. 
 
 OF THE EAR. 
 
 The figure and situation of the outer ear needs 
 no description. Its inner substance is cartilage, 
 which preserves its form without being liable 
 to break. Its use is to collect sounds, and direct 
 them into the meatus auditorius, which is the 
 passage that leads to the drum ; this passage is lin- 
 ed with a glandular membrane, in which also is 
 some hair ; the cerumen which is separated by these 
 glands, being spread all over this membrane, and 
 its hairs, serve to defend the membrane from the 
 
OF THE EAR. 
 
 305 
 
 outer air, and to entangle any insect that might 
 otherwise get into the ear. Sometimes this wax 
 being separated in too great quantity, it fills up 
 the passage and causes deafness ; and those great 
 discharges of matter from the meatus auditorius, 
 which are commonly called imposthumes in the 
 ear, I think, can be nothing else but ulcerations, or 
 great secretions from these glands. At the farther 
 end of the meatus auditorius lies the membrana tym- 
 pani, which is extended upon a bony ridge almost 
 circular. Its situation in men and brutes is nearly 
 horizontal, inclined towards the meatus auditorius, 
 which is the best position to receive sounds ; a 
 great part of them being ordinarily reverberated 
 from the earth. In men and brutes it is concave 
 outward, but in birds it is convex outward, so as to 
 make the upper side of it nearly perpendicular to 
 the horizon, which seems fitter to hear each other’s 
 sounds when they are high in the air, where they 
 can receive but little reverberated sound. This 
 membrane does not entirely close the passage, but 
 has on one side a small aperture covered with a 
 valve. I found it once half open in a man that I 
 dissected, who had not been deaf ; and I have seen 
 a man smoke a whole pipe of tobacco out through 
 his ears, which must go from the mouth through 
 the eu§tachian tube, and through the tympanum ; 
 yet this man heard perfectly well. These cases oc- 
 casioned me to break the tympanum in both ears 
 of a dog, and it did not destroy his hearing, but for 
 Q q 
 
306 
 
 OF THE EAR. 
 
 some time he received strong sounds with great 
 horror. Mr. St. Andre has assured me, that a 
 patient of his had the tympanum destroyed by an 
 ulcer, and the auditory bones cast out, without de- 
 stroying his hearing. From these and other like 
 cases it may be concluded, that the membrana tym- 
 pani, though useful in hearing, is not the seat of 
 that sense ; and if any disease in that membrane 
 should obstruct the passage of sounds to the inter- 
 nal parts of the ear, which are the seat of that 
 sense, an artificial passage through that membrane 
 might recover hearing, as the removing the crystal- 
 line humour, when that obstructs the light, recov- 
 ers sight. Some years since a malefactor was par- 
 doned on condition that he suffered this experiment, 
 but he falling ill of a fever, the operation was de- 
 ferred, during which time there was so great a 
 public clamour raised against it that it was afterwards 
 thought fit to be forbid. In very young children 
 I have always found this membrane covered with 
 mucus, which seems necessary to prevent sounds 
 from affecting them too much, there being no pro- 
 vision to shut the ears, as there is for the eyes. A 
 gentleman well known in this city, having had 
 four children born deaf, was advised to lay blisters 
 upon the heads of the next children he might have, 
 which he did to three which were born afterward, 
 and every oiie’'of them heard well. It seems not 
 unreasonable to suppose that too great a quantity of 
 this mucus upon the drum might be the cause of 
 
@T THE EAR. 
 
 307 
 
 deafness in the four children, and that the discharge 
 made by the blisters in the latter cases was the cause 
 of their escaping the same misfortune. 
 
 Into the middle of the tympanum is extended 
 a small bone called malleus, whose other end is 
 articulated to a bone called incus, which is also ar- 
 ticulated by the intervention of an exceeding small 
 one, called orbiculare, to a fourth bone called sta- 
 pes. These bones are contained in that cavity be- 
 hind the tympanum, which is called the barrel of 
 the ear but some anatomists call the barrel only 
 tympanum, and the membrane membrana tympani. 
 The malleus being moved inward by the mus- 
 culus obliquus interims, or trochlearis, it extends 
 the tympanum that it may be the more affected by 
 impulse of sounds when they are too weak. This 
 muscle rises from the cartilaginous part of the eu- 
 stachian tube, and passing from thence in a proper 
 groove, it is reflected under a small process, and 
 thence passes on perpendicular to the tympanum, 
 to be inserted into the handle of the malleus, 
 sometimes with a double tendon. Parallel to this 
 muscle lies another extensor of the tympanum, 
 called obliquus externus ; it arises from the outer 
 and upper part of the eustachian tube, and passing 
 through the same hole with the chorda tympani* 
 which is a branch of the fifth pair of nerves, it is 
 inserted into a long- orocess of the malleus : this 
 is not so obviously an extensor as to be known 
 'to be so without an experiment. The muscle 
 
SOS or the ear. 
 
 which relaxes this membrane is called externus 
 tympani ; it arises from the upper part of the au- 
 ditory passage, under the membrane which lines 
 that passage, and is inserted into the upper process 
 of the malleus. The relaxation of the tympanum 
 is made by this muscle, without our knowledge, 
 when sounds are too strong ; and as the pupil of 
 the eye is contracted when we have too much 
 light, and dilated when there is too little, from 
 what cause soever, so when sounds are too low, 
 or the sense of hearing imperfect, from whatever 
 cause, the extensors of the tympanum stretch it to 
 make the impulse of sounds more effectual upon 
 it, just as in the case of the common drum, and 
 the chords of any musical instrument. From the 
 cavity behind the tympanum, which is called the 
 barrel of the ear, goes the eustachian tube, or 
 iter ad palatum ; it ends cartilaginous behind the 
 palate. This passage seems to be exactly of the 
 same use with the hole in the side of the common 
 drum, that is, to let the air pass in and out from 
 the barrel of the ear to make the membrane vibrate 
 the better, and perhaps in the ear, which is closer 
 than a common drum, to let air in or out as it 
 alters in density ; and if any fluid should be sepa- 
 rated in the barrel of the ear, to give it a passage 
 out. This passage being obstructed, as it is some- 
 times, by a large polypus behind the uvula, it 
 causes great difficulty of hearing, and sometimes, 
 when the meatus auditorius is obstructed, a man 
 
6F THE EAR. 
 
 309 
 
 opening his mouth wide, will hear pretty well 
 through this passage, which is often so open, as 
 that syringing water through the nose, it shall pass 
 through into the barrel of the ear, and cause deaf- 
 ness for some time. If any one would try how 
 he can hear this way, let him stop his ears, and 
 take between his teeth the end of a wire, or chord 
 that will vibrate well, and holding the other end, 
 strike it, and the sound that he hears will be 
 through this passage. To the stapes there is one 
 muscle, called musculus stapedis ; it lies in a long 
 channel, and ending in the stapes, it serves so pull 
 the stapes off of the fenestra ovalis, which other- 
 wise it covers. Besides the fenestra ovalis, there 
 is another near it, somewhat less, called rotunda ; 
 these two holes lead to a cavity called vestibulum, 
 which leads into other cavities aptly called cochlea, 
 and three semicircular canals, or all together the 
 labyrinth, in which are spread the auditory nerves, 
 to receive and convey the impulse of sounds to 
 the common sensorium the brain ; and surely the 
 chorda tympani, which is a branch of the fifth 
 pair of nerves, may also convey these sensations 
 to the brain. The two holes, called fenestra ovalis 
 and rotunda, are closed with a fine membrane, like 
 the membrane called the drum, and the larger 
 being occasionally covered and uncovered by the 
 stapes, sounds are thereby made to influence more 
 or less, as best serves for hearing ; and this advan- 
 tage being added to that of a lax or tense tympa- 
 
310 SENSES OF SMELLING, 
 
 imm, the effect of sounds may be greatly increased 
 or lessened upon the auditory nerves, expanded in 
 the labyrinth. In the strongest sounds, the tympa- 
 num may be lax, and the fenestra ovalis covered ; 
 and for the lowest, the tympanum tense, and the 
 fenestra uncovered. If sounds propagated in the 
 ear were heard less, we might often be in danger 
 before we were apprised of it j and if the organs of 
 hearing were much more perfect, unless our un- 
 derstandings were so too, we should commonly hear 
 more things at once than we could attend to. 
 
 CHAPTER VI, 
 
 OF THE SENSES OF SMELLING, TASTING, ANB 
 FEELING. 
 
 The sense of smelling is made by the effluvia, 
 which are conveyed by the air to the nerves, 
 ending in the membranes which line the nose and 
 its lamella. In men these lamella are few, and 
 the passage through the nose not difficult ; hence 
 fewer effluvia v/ill strike the nerves, than in ani- 
 mals of more exquisite smell, whose noses being 
 full of lamella, and the passage for the air narrow 
 and crooked, few of the effluvia escape one place 
 or another ; besides, their olfactory nerves may be 
 more sensible. Fish, though they have no noses, 
 yet in their mouths they may taste effluvia in the 
 water, as surely those fish do, who seek their prey 
 
TASTING, AND FEELING. 
 
 311 
 
 in the darkest nights, and in great depths of water, 
 there being more nerves disposed in their mouths 
 than through their whole bodies beside, the optic 
 excepted ; and it seems as if it was done for this 
 purpose ; for the mere sense of tasting is ordinari- 
 ly less curious in them than in land animals ; 
 in baiting eel-baskets, if the bait has lain long in 
 water, it is seldom followed ; but upon scarifying 
 it afresh, which will make it emit new effluvia, 
 it serves as a fresh bait. The sense of tasting is 
 made in the like manner upon the nerves which 
 line the mouth, as is that of feeling upon the nerves 
 distributed throughout the body ; of which I should 
 speak more in this place, if I had not done it al- 
 ready in the chapter of the nerves. 
 
312 
 
 TABLES'. 
 
 TABLE XX XL 
 
 1 The under side of the bladder. 
 
 2 The ureters. 
 
 3 Vasa deferentia. 
 
 4 Vesiculae seminales. 
 
 5 The prostrate gland. 
 
 6 Meatus urinarius. 
 
 7 A transverse section of the corpora cavernosa 
 
 penis. 
 
 3 Corpus cavernosum urethrae. 
 
 9 Urethra. 
 
 10 Septum penis. 
 
 11 The septum between the corpus cavernosum 
 
 urethrae, and that of the penis. 
 
 12 The corpora cavernosa penis divided by the 
 
 septum. 
 
 13 Corpus cavernosum glandis. 
 
P.312. 
 
 nr MV XXXI . 
 

» AB. XXXII. 
 
TABLES. 
 
 313 
 
 TABLE XXXII. 
 
 1 That side of the uterus which is next the gut. 
 
 2 The fallopian tubes. 
 
 3 The fimbriae. 
 
 4 Ovaria. 
 
 5 The mouth of the uterus. 
 
 6 Ligamenta rotunda. 
 
 7 The inside of the vagina. 
 
 8 The orifice of the meatus urinarius. 
 
 9 The glans clitoridis. 
 
 10 The external labia of the vagina. 
 
 11 The nymphae, which are continued from the 
 
 praeputium clitoridis. 
 
 a r 
 
314 
 
 TABLES. 
 
 TABLE XXXIII. 
 
 The parts of an hermaphrodite negro, which was 
 neither sex perfect, but a wonderful mixture of 
 both. This person was twenty six years of age, 
 and in shape perfectly male. 
 
 1 A clitoris, when erected, almost as large as a 
 
 penis. 
 
 2 The glands of the clitoris. 
 
 3 Labia, or a divided scrotum ; in which were 
 
 perfect testicles with ail the vessels. 
 
 4 Nymphae. 
 
 5 The entrance into the vagina, where were carun- 
 
 culae myrtiformes. 
 
 6 Furca virginis. 
 
 The lower ligure represents another her- 
 maphrodite, whose shape was rather female 
 than male, but too young to have female 
 breasts, or a beard, like a male, Xpon the 
 face. . . 
 
 7 The glans clitoridis. 
 
 8 Nymphae. 
 
 9 Labia with testicles in them, divaricated to 
 
 shew the parts between, but in their natural 
 situation very like the other, as the other 
 when divaricated resembled this. 
 
 10 The entrance into the vagina. 
 
 11 Furca virginis. 
 
 O 
 
ta r. X'X \ m 
 

 
 
 
TAB . XX XIV. 
 
 F.315. 
 
TABLES. 
 
 315 
 
 TABLE XXXIV. 
 
 1 The right ventricle of a foetus distended with 
 
 wax. 
 
 2 The risrht auricle. 
 
 O 
 
 3 The left auricle. 
 
 4 Branches of the pulmonary veins of the right 
 
 lobe of the lungs, those of the left being cut 
 off short. 
 
 5 The arteries of the left lobe of the lungs. 
 
 6 The vena cava descendens. 
 
 7 Aorta ascendens. 
 
 8 Arteria pulmonalis. 
 
 9 Ductus arteriosus. 
 
 10 The under side of a heart of a younger foetus. 
 
 1 1 The right auricle cut open. 
 
 12 The cava descendens cut open. 
 
 13 Tub'erculum Loweri. 
 
 14 The foramen ovale closed with its valve. 
 
 15 The mouth of the coronary veins. 
 
 16 The umbilical vein. 
 
 17 Branches of the vena porta in the liver. 
 
 18 Ductus venosus. 
 
 19 Branches of the cava in the liver. 
 
 20 Vena cava. 
 
316 
 
 TABLES. 
 
 TABLE XXXV. 
 
 1 A cross for an object. 
 
 2 The object represented on the retina at the bot- 
 
 tom of each eye. 
 
 3 The entrance of the optic nerves, in which place 
 
 no object is represented. 
 
 4 Cones, within which all objects placed are dark 
 
 to each eye, the rays from thence falling upon 
 the entrance of the optic nerves ; but that 
 which falls upon the entrance of the optic 
 nerve in one eye, can never fall upon the op- 
 tic nerve in the other. 
 
 5 Pencils of rays from points of the object passing 
 through the crystalline humour, where they 
 converge, to meet in a point on the retina to 
 form vision. 
 

 TAB XX XV. 
 
 / ’ j r ti. 
 
TAB XXXVI. 
 
 P. jjy. 
 
 \ 
 
TABLES. 
 
 317 
 
 TABLE XXXVI. 
 
 1 A knife passed through the tunica sclerotis, un- 
 
 der the cornea before the iris, in order to cut 
 an artificial pupil where the natural one is 
 closed. This operation I have performed 
 several times, with good success ; indeed it 
 cannot fail when the operation is well done, 
 and the eye no otherwise diseased, which is 
 more than can be said for couching a cataract. 
 In this operation great care must be taken to 
 hold open the eyelids without pressing upon 
 the eye, for if the aqueous humour is squeez- 
 ed out before the incision is made in the iris, 
 the eye grows flaccid, and renders the opera- 
 tion difficult. 
 
 2 A crooked needle passed through a proptosis 
 
 of the cornea ; the black line in the cornea 
 encloses the piece to be cut out with a knife. 
 The operation being thus done, the crystal- 
 line humour immediately falls out ; and in a 
 few days the lips of the wound unite. This 
 operation is very useful, and attended with 
 but little pain. I have done the same thing 
 when the whole eye has been so enlarged 
 that the eyelids could not be closed, which 
 has sunk the eye in the head ; but this ope- 
 ration was attended with such violent pain 
 that I cannot much recommend it. 
 
 ) 
 
 1 
 
 ) 
 
 / » 
 
313 
 
 TABLES. 
 
 3 Shews how an opaque scar upon the cornea, by- 
 
 obstructing part of each pencil of rays, makes 
 a dimness of sight without a total loss. 
 
 4 Shews how a cataract or obstruction of the 
 
 crystalline humour will obstruct the light 
 which is before it. And how some side- 
 light may pass to the retina through the 
 aqueous humour, but not being brought into 
 a focus gives only a sense of light without 
 vision. 
 
 
 t 
 
 A 
 
 ‘ V 
 

TABLES. 
 
 319 
 
 TABLE XXXVII. 
 
 1 A bone taken out from the first process of the 
 
 dura mater not far from the crista galli. 
 
 2 A bone taken out of the muscular part of the 
 
 heart of a man. 
 
 3 The under side of a bone taken out of a frac- 
 
 tured scull. 
 
 4 The upper side of a bone from the same scull. 
 
 where the operation of the trepan had been 
 thrice made. This girl was brought into the 
 hospital a week after the accident. I im- 
 mediately opened the scalp, and let out about 
 two ounces of grumous blood, and laid the 
 scull bare about four inches one way, and 
 three the other, and tied the blood vessels, 
 that I might make the operation without 
 much difficulty soon after. The fracture 
 extended across the os bregmatis from the 
 sagittal suture to the temporal bone ; that 
 part next the os frontis was depressed equal 
 to its thickness, and a great deal of extrava- 
 sated blood, and some matter, lay under the 
 other part of the same bone. I made two 
 perforations with the trephine, close to the 
 fracture, that I might raise it up steadily 
 through both, and have more room for the 
 extravasated blood to discharge from under 
 the scull, which had discharged before in 
 ) great quantity through the fracture. But 
 
 ) 
 
TABLES. 
 
 nevertheless, ten days after the former opera- 
 tion, I was obliged to make .another perfora- 
 tion to discharge the matter more freely j for, 
 during a month, the matter ran through all 
 her dressings down her face twice every day, 
 and was exceedingly fetid, and for the space 
 of three months the matter decreased very 
 little in quantity, but grew less and less of- 
 fensive. September tire thirteenth, the least 
 of the bones was taken out ; and on Sep- 
 tember the twenty ninth, the large one ; 
 after which time the matter was good, and 
 not too much in quantity. Each of these 
 bones is through both tables, for the motion 
 in the brain was seen, only some little parts 
 of the lesser bone remaining, a callus was 
 formed from them ; but where the great one 
 came away there was no callus, only a com- 
 mon cicatrix ; and besides these, many little 
 bits of bone came away in the dressings : she 
 was soon after cured, and has remained well 
 many years. 
 
TAB. xxx vm 
 
TABLES. 
 
 321 
 
 TABLE XXXVIII. 
 
 The figure of Samuel Wood, a miller, whose 
 arm with the scapula was torn off from his 
 body, by a rope winding round it, the other 
 end being fastened to the coggs of a mill. 
 This happened in the year 1737. The vessels 
 being thus stretched bled very little, the arte- 
 ries and nerves were drawn out of the arm ; 
 the surgeon who was first called placed them 
 within the wound, and dressed it superficially. 
 The next day he was put under Mr. Ferne’s 
 care, at St. Thomas’s hospital, but he did not 
 remove the dressings for some days. The pa- 
 tient had no severe symptoms, and the wound 
 was cured by superficial dressings only, the nat- 
 ural skin being left almost sufficient to cover 
 it ; which should in all cases be done as much as 
 may be. About twenty years since I introduced 
 the method of amputating, by first dividing the 
 skin and membrana adiposa, lower than the place 
 where the operation was to be finished, the ad- 
 vantages of which are now sufficiently known. 
 
 1 The end of the clavicle. 
 
 2 The cicatrix. 
 
 3 The subscapularis muscle. 
 
 4 The cubit broke in two places. 
 
322 
 
 TABLES. 
 
 TABLE XXXIX 
 
 Represents the case of John Heysham, whoy 
 the Friday before Easter, in the year 1721, by 
 overstraining himself at work, had a rupture 
 of the intestines into the scrotum, which could 
 by no means be reduced. He Was brought 
 into St. Thomas’s hospital the Monday follow- 
 ing, and I would have performed the operation 
 immediately, but he refusing to submit, it was 
 deferred till Tuesday morning, when, he be- 
 ing willing, I performed the operation, and 
 making a large wound in the bottom of the 
 abdomen, the intestines were easily reduced, 
 and near a quart of water wa: discharged out 
 of the scrotum at the same _ me. There had 
 been a rupture of the omentum before, which 
 being united to the scrotum and spermatic ves- 
 sels, I passed a needle with a double ligature 
 (as is expressed in the plate) under that part 
 of the omentum that adhered, so as not to 
 hurt the spermatic vessels ; then cutting out 
 the needle, I tied one of the strings over the 
 upper part of the omentum, and the other 
 over the lower, and then cut off as much of 
 it as was in the way. My reason for tying in 
 this manner was to secure the blood vessels, 
 which, I think, could not be done so well 
 with one ligature, because of the largeness of 
 

TABLES, 
 
 S2S 
 
 the adhesion and the texture of the omentum., 
 which renders it too liable to be torn by such 
 a bandage. Three days after the operation an 
 erysipelas began in his legs, and spread all over 
 his body, the cuticle every where peeling off j 
 yet he recovered, and continues in a good state 
 of health. After he was cured, at first he wore 
 a small truss, but left it off in a short time, 
 and now feels no inconvenience from it, though 
 he lives by hard labour. 
 
324 
 
 TABLES. 
 
 TABLE XL. 
 
 The case of Margaret White, the wife of 
 John White, a pensioner in the Fishmongers 
 alms-houses at Newington in Surry. In the 
 fiftieth year of her age, she had a rupture at 
 her navel, which continued till her seventy- 
 third year, when, after a fit of the colic, it 
 mortified, and she being presently after taken 
 with a vomiting, it burst. I went to her, and 
 found her in this condition, with about six and 
 twenty inches and a half of the gut hanging 
 out, mortified. 1 took away what was morti- 
 fied, and left the end of the sound gut hanging 
 out at the navel, to which it afterwards ad- 
 hered ; she recovered and lived many years 
 after, voiding the excrements through the in- 
 testine at the navel j and though the ulcer was 
 so large, after the mortification separated, that 
 the breadth of two guts was seen ; yet they 
 never at any time protruded out at the wound, 
 though she was taken out of her bed, and sat up 
 every day. 
 
 1 The gut. 
 
 2 The cicatrix of the wound. 
 
TAB. XT, 
 
 F. 3 % 
 
CUTTING FOR THE STONE, 
 
 325 
 
 CHAPTER VII. 
 
 A SHORT HISTORICAL ACCOUNT OF CUTTING FOR 
 THE STONE. 
 
 The most ancient way of cutting for the 
 stone is that described by Celsus, which was 
 indeed cutting upon the gripe, but in a very dif- 
 ferent manner from that operation in later ages, 
 for he directs a lunated incision with the horns 
 towards the coccyges, which was plainly that the 
 gut might be pressed downwards to avoid wound- 
 ing it, and then a transverse incision upon the 
 stone might be made safely, but not in very young 
 children, for want of room, nor after puberty, 
 for then the prostatse are too large to allow of 
 this operation ; therefore they did not usually cut 
 any younger than nine years, nor older than four- 
 teen. Afterwards, but when we know not, this 
 operation was improved by cutting lower, and on 
 one side, which is the operation now called cutting 
 on the gripe, or with the lesser apparatus. 
 
 In the year 1524, Marianus published the 
 method of cutting by the greater apparatus, now 
 commonly called the old way, but he owns it was 
 invented by his master Johannes de Romanis. 
 
 In the year 1697, Frere Jacques came to 
 Paris, full of reputation for the success of his new 
 operation for the stone ; he soon obtained leave to 
 cut in the hospitals, where great numbers of his 
 
326 
 
 CUTTING FOR THE STONE. 
 
 patients dying, and being dissected, they were 
 found with their bladders cut through, guts 
 wounded, &c. which brought the operation into 
 disgrace, as Mery and Dionis have related, who 
 saw these things. They say he performed the ope- 
 ration without any direction, and without any 
 knowledge of the parts he was to cut ; a thing not 
 to be mentioned without horror ! But of late his 
 character has been set in a very different light j 
 and though it is more than probable he himself 
 knew not what he did, yet there are now, who pre- 
 tend to tell us exactly ; though if their testimonies 
 are to be regarded, who saw him operate, there is 
 no place that he did not cut one time or other, and 
 therefore he may have a sort of right to be called 
 the inventor of any operation for the stone that can 
 ever be performed in these parts. It is also owned 
 that he sometimes had great success, which was 
 enough to put others of that nation upon trying of 
 it in a more judicious manner ; but if there were 
 such, failing of success, they have concealed their 
 experiments. 
 
 Mr. Rau of Amsterdam, who saw F. Jacques 
 operate, professed to do his operation with the 
 necessary improvement of a grooved staff, which if 
 Jacques ever used, he surely learned that of 
 Rau. He succeeded wonderfully ; and if he, who 
 was an excellent anatomist, may be allowed to 
 understand his own operation, it was directly into 
 the bladder, without wounding either the urethra 
 
CUTTING FOR THE STONE. 327 
 
 4r the prostrates : besides this, other competent 
 judges, who were witnesses to his operations, have 
 bore the same testimony. 
 
 In the year 1717-18, Doctor James Doug- 
 lass, in a paper presented to the Royal Society, 
 demonstrated from the anatomy of the parts, that 
 the high operation for the stone might be prac- 
 tised; which had been once performed by Franco 
 injudiciously, and by him disrecommended, though 
 his patient recovered ; and afterwards strongly 
 recommended, but not practised by Rosset. Yet 
 no one undertook it, till his brother, Mr. John 
 Douglass, about three years after, performed it, 
 and with great applause, his two first patients re- 
 covering. Soon after, a surgeon of St. Thomas’s 
 hospital cut two, who both recovered ; but the 
 same gentleman afterwards cutting two, who mis- 
 carried by the cutting or bursting of the peritonae- 
 um, so that the guts appeared, this way imme- 
 diately became as much decried as it was before 
 commended ; upon which the surgeons of St. Bar- 
 tholomew’s hospital, who had prepared to perform 
 this operation, altered their resolution, and went 
 on in the old way. The next season, it being my 
 turn in St. Thomas’s, I resumed the high way, 
 and cutting nine with success, it came again in 
 vogue ; after that every lithotomist of both hos- 
 pitals practised it ; but the peritonaeum being 
 often cut or burst twice in my practice, though 
 some of these recovered, and sometimes the 
 
32 & CUTTING FOR THE STONE. 
 
 bladder itself was burst, from injecting too muck 
 water, which generally proved fatal in a day or 
 two. Another inconvenience attended every ope- 
 ration of this kind, which was, that the urine’s 
 lying continually in the wound retarded the cure, 
 but then it was never followed with an inconti- 
 nence of urine. What the success of the several 
 operators was, I will not take the liberty to pub- 
 lish ; but for my own, exclusive of the two before 
 mentioned, I lost no more than one in seven, 
 which is more than any one else that I know of 
 could say ; whereas in the old way, even at Paris, 
 from a fair calculation of above 800 patients, it 
 appears that near two in five died. And though 
 this operation came into universal discredit, I must 
 declare it my opinion, that it is much better than 
 the old way, to which they all returned, except 
 myself, who would not have left the high way 
 but for the hopes I had of a better ; being well 
 assured, that it might hereafter be practised with 
 greater success ; these fatal accidents having pret- 
 ty well shewn how much water might be inject- 
 ed, and how large the wound might safely be 
 made. But hearing of the great success of Mr. 
 Rau, professor of anatomy at Leyden, I deter- 
 mined to try, though not in his manner, to cut 
 directly into the bladder ; and as his operation was 
 an improvement of Friar Jacques, I endeavoured 
 to improve upon him, by filling the bladder, as 
 Douglass had done in the high way, with water. 
 
cutting £or The ston£. 329 
 
 leaving the catheter in, and then cutting on the 
 outside of the catheter into the bladder, in the 
 same place as upon the gripe, which I could do 
 very readily, and take out a stone of any size with 
 more ease than in any other way. My patients, 
 for some days after the operation, seemed out of 
 danger ; but the urine which came out of the 
 bladder continually lodging upon the Cellular 
 membrane on the outside of the rectum, made 
 foetid ulcers, attended with a vast discharge of 
 stinking matter : and from this cause I lost four 
 patients out of ten. The case of one which escaped 
 was very remarkable ; a few days after he was 
 cut, he was seized with a great pain in his back 
 and legs, with very little power to move them ; 
 upon which he turned upon his face, and rested 
 almost constantly upon his knees and elbow's above 
 a fortnight together, having no ease in any other 
 posture all that while ; at length his urine coming 
 all the right way, his wound soon healed, and he 
 recovered the use of his back and limbs. I think 
 all these severe symptoms could proceed from no 
 other cause than the urine and matter somehow 
 offending the great nerves ; which come out of 
 the os sacrum to 2:0 to the lower limbs. I then 
 
 o 
 
 tried to cut into the bladder, in the same manner 
 that Mr. Rau was commonly reported to do, but 
 there had the same inconvenience from the urine’s 
 lodging upon the cellular membrane on the out« 
 side of the intestinum rectum. Upon these dis» 
 t t 
 
330 CUTTING TOR THE STOnU. 
 
 appointments, I contrived the manner of cutting^ 
 which is now called the lateral way. This ope- 
 ration I do in the following manner : I tie the 
 patient as for the greater apparatus, but lay him 
 upon a blanket several doubles upon an horizontal 
 table three feet high, with his head only raised. 
 I first make as long an incision as I can, beginning 
 near the place where the old operation ends, and 
 cutting down between the musculus accelerator 
 urinae, and erector penis, and by the side of the' 
 intestinum rectum : I then feel for the staff, 
 holding down the gut all the while with one or 
 two fingers of my left hand, and cut upon it ill 
 that part of the urethra which lies beyond the 
 corpora cavernosa urethrae, and in the prostate 
 gland, cutting from below upwards, to avoid 
 wounding the gut ; and then passing the gorget 
 very carefully in the groove of the staff into the 
 bladder, bear the point of the gorget hard against 
 the staff, observing all the while that they do 
 not separate, and let the gorget slip to the out- 
 side of the bladder ; then I pass the forceps into 
 the right side of the bladder, the wound being 
 on the left side of the perinaeum ; and as they 
 pass, carefully attend- to their entering the blad- 
 der, which is known by their overcoming a strait- 
 ness which there will be in the place of the wound j, 
 then taking care to push them no farther, that 
 the bladder may not be hurt, I first feel for the 
 stone with the end of them, which having; felt. 
 
CUTTING FOR THE STONE. 
 
 331 
 
 I open the forceps and slide one blade underneath 
 it, and the other at top ; and if I apprehend the 
 stone is not in the right place of the forceps, I 
 shift it before I offer to extract, and then extract 
 it very deliberately, that it may not slip suddenly 
 out of the forceps, and that the parts of the 
 wound may have time to stretch, taking great care 
 not to gripe it so hard as to break it, and if I find 
 the stone very large, I again cut upon it as it is 
 held in the forceps. Here I must take notice, it is 
 very convenient to have the bladder empty of urine 
 before the operation, for, if there is any quantity 
 to flow out of the bladder at the passing in of the 
 gorget, the bladder does not contract but collapse 
 into folds, which makes it difficult to lay hold 
 <of the stone without hurting the bladder ; but 
 if the bladder is contracted, it is so easy to lay 
 hold of it, that I have never been delayed one 
 moment, unless the stone was very small. Last- 
 ly, I tie the blood vessels by the help of a crook- 
 ed needle, and use no other dressing than a lit- 
 tle bit of lint besmeared with blood, that it may 
 not stick too long in the wound, and all the dress- 
 ings during the cure are very slight, almost super- 
 ficial, and without any bandage to retain them r, 
 because that will be wetted with urine, and gall 
 the skin. At first I keep the patient very cool to 
 prevent bleeding, and sometimes apply a rag dipt 
 in cold water, to the wound, and to the genital 
 parts, which I have found very useful in hot 
 
332 CUTTING FOR THE STONE. 
 
 weather particularly. In children it is often alone 
 sufficient to stop the bleeding, and always helpful 
 in men. The day before the operation, I give a 
 purge to empty the guts, and never neglect to 
 give some laxative medicine or clyster a few days 
 after, if the belly is at all tense, or if they have not 
 a natural stool. What moved me to try this way, 
 if I may be allowed to know my own thoughts, 
 was the consideration of women scarce ever dying 
 of this operation ; from which I concluded, that if 
 I could cut into the urethra, beyond the corpora ca- 
 vernosa urethrae, the operation would be nearly as 
 safe in men as women. 
 
 What success I have had in my private practice 
 I have kept no account of, because I had no inten- 
 tion to publish it, that not being sufficiently wit- 
 nessed. Publicly in St. Thomas’s hospital I have 
 cut two hundred and thirteen ; of the first fifty, 
 only three died ; of the second fifty, three ; of the 
 third fifty, eight ; and of the last sixty three, six. 
 Several of these patients had the smallpox during 
 their cure, some of whom died, but I think not 
 more in proportion than what usually die of that 
 distemper ; these are not reckoned among those 
 who died of the operation. The reason why so 
 few died in the two first fifties was, at that time 
 few very bad cases offered ; in the third, the ope- 
 ration being in high request, even the most aged 
 and most miserable cases expected to be saved by 
 it 3 besides, at that time, I made the operation 
 
CUTTING TOR THE STONE. 
 
 333 
 
 lower, in hopes of improving it, but found I 
 was mistaken. But what is of most conse* 
 quence to be known is the ages of those who re* 
 covered, and those who died. Of these, under 
 ten years of age one hundred and five were cut, 
 three died ; between ten and twenty, sixty two 
 cut, four died ; twenty and thirty, twelve cut, 
 three died ; thirty and forty, ten cut, two died ; 
 forty and fifty, ten cut, two died ; fifty and 
 sixty, seven cut, four died ; sixty and seventy, 
 five cut, one died ; between seventy and eighty, 
 two cut, one died. Of those who recovered the 
 three biggest stones were ^ xii, x|, and viii, and 
 the greatest number of stones in any one person 
 was thirty three. One of the three that died out 
 of the hundred and five, was very ill with a 
 whooping cough ; another bled to death by an 
 artery into the bladder, it being very hot weather 
 at that time : but this accident taught me after* 
 wards, whenever a vessel bled that I could not 
 find, to dilate the wound with a knife, till I 
 could see it. Now if Jacques or others, who 
 of late have been said to have performed this 
 operation, whether by design or chance, did not 
 take care to secure the blood vessels, which as 
 yet has not been supposed, whatever their dexter- 
 ity in operating might be, their suceess at least 
 can be no secret, for many of their children and 
 jnost of their men patients must have bled to 
 plealh. If I have any reputation in this way ? 
 
334 
 
 CUTTING TOR THE STONE. 
 
 I have earned it dearly, for no one ever endured 
 more anxiety and sickness before an operation, yet 
 from the time I began to operate, all uneasiness ceas- 
 ed ; and if I have had better success than some oth- 
 ers, I do not impute it to more knowledge, but to 
 the happiness of a mind that was never ruffled or 
 disconcerted, and a hand that never trembled during 
 any operation. 
 
INDEX 
 
 A 
 
 DIPOSE membrane 
 
 its diseases 
 
 Alantois 
 
 Amnion 
 
 137 
 
 138 
 280 
 278 
 
 does its liquor serve as nourishment ? 
 
 Amputation, how is the circulation kept up after it ? 203 
 
 - — occasioned, and proving fatal from the cramp 207 
 
 «— — in mortifications ought to succeed the sepa- 
 ration ...... 208 
 
 Anasarca = - - - - 130 
 
 Anchylosis , how formed ... 8 
 
 Aneurism - - - - - 187 
 
 Animal body, what 1 
 
 — — ■ — — its constituent parts ... 2 
 
 Animal, why larger have slower pulses, and less vig- 
 our in motion ... 200 
 
 — — — why inactive ones require less food, and are 
 
 not so suddenly destroyed by wounds - 207 
 
 Antra. Vide Sinus maxillce sup. 
 
 Aorta , frequently ossified near the heart - - 182 
 
 — - — • its valves covered with chalk - - 182 
 
 ■ preternaturally distended - - - 182 
 
 — — - traced - - . - - 183 
 
 Aqueous humour of the eye .... 296 
 
 Arm, right, why more used than the left - 24 
 
 Artery, coronary - - - =184 
 
 *— carotids, why rising differently - - 184 
 
336 
 
 INDEX. 
 
 Arteiy, cervical - 
 
 subclavian, axillary, Etc.- * t 
 
 ■ intercostal, See. - 
 
 phrenic, &c. - 
 
 iliac - 
 
 ~ inguinal, &c, - 
 
 pulmonary . «■ 
 
 Arteries, what J' - * 
 
 • become bony 
 
 coats - - 
 
 the angles and laws of ramification 
 
 the force of their contractions 
 
 186 
 
 - 186 
 
 188 
 188 
 - 189 
 
 190 
 183 
 
 - 2 
 5 
 
 194, 200 
 
 195 
 
 196 
 
 motion of the blood in them and in the veins 199, &c. 
 
 Arachnoides of the brain - - - - - 221 
 
 Atlas , or first ’vertebra 22 
 
 Barrenness of women - 276 
 
 Bile, in what quantity - « . 164 
 
 concreting, forms stones - - - 166 
 
 Biliary ducts - - - - 163 
 
 obstructed - - ~ ~ - 166 
 
 Bladder of urine ^ 260 
 
 seldom ulcerated - 261 
 
 Blood, quantity, celerity of its motion, &c. - 206 
 
 - — — extravasated, requires first purging, and then 
 
 warm attenuant - 208 
 
 Blood letting - - - 89 
 
 what artery in danger - - - 187 
 
 Bones, what - . 3 
 
 - — — use - 4 
 
 fibres - - - - 4, 9 
 
 — — — how ossify and grow » 4 
 
 ■ — - sometimes decrease or waste - 5 
 
 • — — why hollow & 
 
337 
 
 Page 
 
 7 
 
 7 
 
 9 
 
 9 
 
 INDEX. 
 
 Bones, their place supplied by shells in small animals 
 
 broken, how united by the callus 
 
 ■- — — have not visible lamella ... 
 
 • their compact and spongy substance 
 
 distorted or fractured, cured by an indurating 
 
 paste ... -37 
 
 ■ their diseases, particulai'ly caries - S3 
 
 ■ of the cranium - - - - 11 
 
 — trunk - - - - 21 
 
 — upper limb - - - 29 
 
 - — ■ — lower limb ... 34 
 
 — — internal ear ... 3 07 
 
 Bony excrescences .... 5 
 
 Brain ..... 222 
 
 • — — full of water in a lethargy - . 224 
 
 — — its state in an apoplexy ... 224 
 
 - — scirrhous humours in the cerebrum - 225 
 
 imposthumations of the cerebrum - 225 
 
 Breast and its cancer ... . 140 
 
 Cacum , or appendix vermiformis - • 156 
 
 Callus , unites fractured bones - - 7 
 
 Canalis arteriosus .... 284- 
 
 Cancer - 140 
 
 Caries of bones - - - . 39 
 
 Carpus , bones of 32 
 
 Cartilages, what - - - . 3 
 
 — — ■ subject to ossification 
 - — — swelled in rickets - 
 
 — — prevent contiguous moveable bones from uniting 
 
 — eroded, occasion anchylosis 
 
 where placed and use 
 moveable in the joint of the jaw 
 
 5 
 5 
 8 
 8 
 
 41, &c. 
 41 
 
 U U 
 
SB'S tND"ETC. 
 
 Fa igji: 
 
 Cartilages, semilunur in the knee - Z 42 
 
 Cartilago ensiformis - - - - 28 
 
 Caruncula lachrymalis » 291 
 
 Carunculce myrtiformes ... 273 
 
 urethrae - 268 
 
 Castration, how to secure the vessels - - 265 
 
 Catamenia - - - - -2 75 
 
 Cataract, why the patient does not discern objects, 
 
 though sensible of light and colours - 300 
 
 Cerebellum ..... 223 
 
 its wounds cause sudden death - - 224 
 
 Cerebrum ..... 222 
 
 ■ its wounds n9t mortal ... 224 
 
 Chorion - - 278 
 
 Choroides oeuli - - 293 
 
 Circulation, the complete revolution - - 217 
 
 ■ - in small vessels, and in living animals - 204 
 
 Clavicida ..... 29 
 
 Clitoris ..... 272 
 
 Colon - - - - - -156 
 
 Conception .... 269, 276 
 
 Conjunctiva oculi •> 291 
 
 Cornea oculi ..... 291 
 
 » — a great refractor of light - - 298 
 
 Couching, not so much refraction in the eye after the 
 
 operation .... 298 
 
 history of a young gentleman - - 300 
 
 Cowper , Mr. his operation on the antrum - 19 
 
 Cramp, occasioning first amputation, and then death 207 
 Cranium , why composed of several bones - 12 
 
 Crystalline humour .... 297 
 
 ■ a lens for refraction 297, 298, 299 
 
 134 
 
 Guticula 
 
INDEX* 
 
 Cuticula , its diseases 
 Cutis 
 
 — — - small painful tumours under it 
 Chylification - 
 
 Deafness caused by redundant cerumen 
 — — - in some cases, perhaps, might he cured by per- 
 forating the membrana tympani 
 — = — in three cases, probably, prevented by blistering 
 immediately after birth 
 
 ■— — • caused by the polypus of the nose compressing 
 the Eustachian tube 
 Dentes. Vide Teeth. 
 
 Digestion of the aliment ... 152 , 
 
 Dislocation of the thigh 
 
 — — — — — ■ knee ... 
 
 Dropsy and tapping .... 
 
 — = — ■ of the liver 
 
 — — true ascites never cured ... 
 
 — — in the duplicature of the peritonaeum 148, 
 
 Ductus arteriosus .... 
 
 — — — how closed ... 
 
 ■ — thoracicus .... 
 
 — venosus .... 
 
 Duodenum ..... 
 
 Dura mater ..... 
 
 — — its sinuses . 
 
 — ossified .... 221, 
 
 Ear, external .... 
 
 imposthumes of 
 
 membrana tympani ... 
 
 naturally perforated 
 broke in a dog, without caus- 
 ing deafness 
 
 335 
 
 Page 
 
 134 
 
 135 
 
 136 
 216 
 
 305 
 
 306 
 306 
 308 
 
 , 216 
 
 44 
 
 45 
 211 
 212 
 215 
 149 
 284 
 28/ 
 169 
 283 
 155 
 218 
 219 
 319 
 
 304 
 
 305 
 305 
 305 
 
 305 
 
340 
 
 INDEX. 
 
 Page 
 
 Ear, membrana tympani destroyed by ulcer, and the 
 
 small bones thrown out, without deafness 305 
 
 306 
 30 7 
 
 308 
 
 309 
 309 
 138 
 265 
 
 8 
 
 234 
 269 
 3 
 
 39, 40 
 
 — — - ■ ■ ■ ■ its perforation proposed 
 
 — small bones, with muscles of the malleus 
 
 Eustachian tube - 
 
 ■ stapes with its muscle 
 
 labyrinth - 
 
 Emphysema - 
 
 Epididymis - 
 
 Epyphysis of bones . 
 
 Epigastrium - - 
 
 Erection of the penis - - 
 
 Excretory vessel - 
 
 Exfoliation of bones - - 
 
 Extravasation. Vide Blood. 
 
 Eye - - - - - 
 
 • — tunica conjunctiva - 
 
 — sclerotis et cornea ... 
 
 — iris processus ciliares - 
 
 ■ — tunica choroides - 
 
 • — retina - 
 
 — humours of ------ 
 
 — inflammations of, require immediate assistance 
 
 — membrana nictitans , in amphibious animals, not for 
 
 refraction - 
 
 Feeling, the sense of 
 Females, why fewer born than males 
 Fibres, what ----- 
 
 Fibula ------ 
 
 Figures of the bones. 
 
 290 
 
 291 
 291 
 291 
 293 
 293 
 
 296 
 299 
 
 297 
 311 
 275 
 
 2 
 
 36 
 
 1. The skeleton of a child twenty months old^J 
 
 I 
 
 The thigh bone of a man sawed through }> 50 
 
 ■ 
 
 The os bregmatis of a foetus of six months J 
 
INDEX. 
 
 } 
 
 341 
 
 Page 
 
 ■2. The head with the lower jaw - - - 51 
 
 3. A section of the scull and upper jaw 
 
 The os sphenoides - - 
 
 The inside of the base of the scull 
 
 4. The trunk .... 
 
 5. The vertebra - 
 
 6. Bones of the arm, fore-arm, and carpus 
 
 7. The hand - 
 
 8. The thigh and leg of the skeleton 
 
 9. The foot of the skeleton 
 
 10. The adult skeleton - 
 
 Figures of the muscles. 
 
 11. A muscular busto - 
 
 12. The fore view of a muscular trunk 
 
 13. The back view of the same 
 
 14. Two muscular arms - 
 
 15. A muscular arm and leg- 
 
 16. Two muscular legs - 
 
 17. A muscular hand - 
 
 Figures of the muscles. 
 
 1 8. A. muscular foot - 
 
 19. A complete muscular figure 
 
 20. The muscular figures of Hercules and Antaeus 1 31 
 Figures of the viscera. 
 
 21. Viscera of the abdomen and thorax in situ 249 
 
 22. The liver, pancreas , spleen, and kidneys, 
 
 with the large vessels of the abdomen , and 
 contents of th e pelvis - 250 
 
 23. The lacteals of the jejunum 
 
 52 
 
 53 
 
 54 
 
 55 
 
 56 
 
 57 
 
 58 
 
 59 
 
 122 
 
 123 
 
 124 
 
 125 
 
 126 
 
 127 
 
 128 
 
 129 
 
 130 
 
 The origin and distribution of the supe- 
 rior mesenteric artery 
 
 24. A full view of the vena portarum 
 
 25. The vena hepaticce 
 
 The biliary and pancreatic ducts 
 
 | 251 
 
 } 
 
 252 
 
542 
 
 INDEX, 
 
 26. Receptaculum chyli et ductus thoracicus 
 
 27. The superior and inferior cubital nerves 
 Course and distribution of humeral artery 
 
 2,8. The parts concerned in V. S. brachii 
 
 A tumor extirpated from the cubital nerve 
 29. The medulla spinalis 
 The intercostal nerve 
 SO. The animalcules in semhie 
 
 The circulation in a fish’s tail 
 A small artery and a vein spread On a 
 membrane 
 
 Figures of the organs of generation. 
 
 31. The bladder, with the prostate gland, 
 
 vesiculce seminales , See. 
 
 A transverse section of the penis 
 A longitudinal section of the penis 
 
 32. The female organs of generation 
 
 33. The parts of two different hermaphrodites 
 Figures of the foetus. 
 
 34. The heart, with its large vessels 
 'The heart, with th t foramen ovale 
 The venal system of the liver 
 
 Figures of the Eye, and Cases of Surgery. 
 
 35. A diagram to illustrate vision, and the dark 
 
 or insensible point of the eye 
 
 36. The operation of imperforated iris 
 The operation for proptosis cornea; 
 
 A diagram, whence dimness of sight from 
 an opacity of the cornea 
 A diagram, whence the sense of light in 
 a cataractous eye - 
 
 37. An ossification in the dura mater 
 
 in the heart 
 
 Two exfoliations of both tables of the scull- 
 
 Pag® 
 
 254 
 
 } 
 
 } 
 
 } 
 
 255 
 
 256 
 
 257 
 
 r 
 
 258 
 
 J> 312 
 
 « 
 
 ■ 
 
 I 
 
 J 
 
 313 
 
 314 
 
 j - 315 
 j- 316 
 
 » 317 
 } 318 
 
INDEX. 
 
 38. Wood, the miller 
 
 39. The Bubonocele performed on Hey sham 
 
 40. White’s exomphalos 
 Fingers, bones of 
 
 Fistula in ano 
 perincEO 
 
 Flea, why numerous joints in its legs 
 Fluids, their proportion to the solids 
 Fcetus , it is nourished by the mouth 
 — — receives red blood from the mother 
 circulation of its blood 
 
 Foramen ovale 
 
 . how closed 
 
 - not open in water animals 
 
 Fra cture, how united by callus 
 how bound up with a paste 
 
 __ — — — of the scull 
 Funis umbilicalis 
 Gall-bladder 
 Ganglion of nerves 
 Gland, what 
 =— structure 
 — — lacrymal 
 lymphatic 
 — — . miliary 
 
 mucilaginous, of joints 
 
 - — - pineal 
 
 — pituitary 
 
 — — salivary 
 ________ — economy 
 
 thymus 
 
 — — thyroide 
 Glandules renales 
 
 543 
 
 Pag® 
 
 321 
 
 322 
 
 - 324 
 
 33 
 
 72, 1 57 
 26 7 
 
 7 
 
 - 206 
 278 
 182 
 
 - 284 
 
 284 
 28 7 
 288 
 7 
 
 - 3 7 
 319 
 283 
 163 
 227 
 
 3 
 
 146 
 290 
 212 
 . 136 
 
 47 
 
 213, 223 
 213, 222 
 
 - 142 
 
 - 145 
 
 - 213 
 
 . 213 
 
 263 
 
344 
 
 Index. 
 
 Gonorrhcca « - - - » 
 
 Gutta serena state of the brain and optic nerves 
 Haemorrhage, why commonly on surfaces 
 Haemorrhoides,how extirpated 
 Hanging kills by interrupting respiration 
 Heart - 
 
 Page’ 
 
 268 
 
 22 S 
 202 
 158 
 
 m 
 
 177 
 
 ossification of its muscular fibres 5, 182, 31$ 
 
 — its basis ulcerated, with pus in the pericardium 181 
 
 — large, lax, and filled with polypi in fatal dropsies 181 
 
 its force - - - - 196 
 
 ■ systole and diastole, why reciprocal . 197 
 
 ■ throws the blood along the whole arterial system 200 
 
 Hernia . Vide Rupture. 
 
 aquosa - 264 
 
 Hydrocele - - - - 263 
 
 Hymen - 273 
 
 ■ imperforated .... 273 
 
 Hypochondrium - - - - 134 
 
 Hypogastrium - - - - 134 
 
 Jaundice - - - - - 166 
 
 Jaw, lower, not ossified - - - 5 
 
 Jejunum - - - - - 156 
 
 Ileum intestinum - - - - 156 
 
 Iliac passion - - - - 160 
 
 Imposthumations, their seat - - 139 
 
 Injection through the arteries into the veins - 203 
 
 Intestines - 155,- — 158 
 
 why such a length of - - 156 
 
 joint of the thigh imposthumated - - 29 
 
 diseases of .... 48 
 
 Iris ------ 291 
 
 — — acts as a sphincter muscle - - 292 
 
 Kidneys - - 295 
 
INDEX. 
 
 Kidneys tubuli , papilla, glands, and pelvis 
 
 one frequently almost consumed 
 
 * — sometimes but one ... 
 
 Labia pudendi - 
 
 Labour, child bearing, why at the usual time 
 Lacteals - - - 
 
 Ligament, what .... 
 
 where placed, and uses 
 
 Ligamenium uteri rotundum - 
 latum - - - 
 
 Lithotomy, an account of 
 
 Liver .... .... 
 
 — — - diseased ...... 
 
 Lobster, its shells and joints .... 
 Lungs .. 4 ..... 
 Luxations of the spine most commonly at the lower 
 dorsal vertebras - 
 
 Lymphseducts ... ... 
 
 Males, why more born than females 
 Mammae ....... 
 
 — — — ■ cancerous ...... 
 
 Marrow, oily ....... 
 
 • bloody ....... 
 
 cells, vesicles, &c. .... 
 
 Maxillary gland .... - 
 
 • scirrhous proving fatal in nine weeks 
 
 Mediastinum ...... 
 
 Medulla oblongata ...... 
 
 — — — — wounded, causes sudden death 
 
 345 
 
 Paa:e 
 
 260 
 
 272 
 
 272 
 
 289 
 
 168 
 
 3 
 
 43, &c. 
 274 
 274 
 325 
 161 
 165 
 212 
 7 
 
 172 
 
 ■ — spinalis - 
 
 Membrana oblongata , its wounds 
 Membrana adiposa 
 
 26 
 
 2, 206 
 275 
 
 139 
 
 140 
 5 
 
 5 
 
 6 
 143 
 143 
 172 
 224 
 224 
 224 
 224 
 137 
 
 W W 
 
346 
 
 INDEX. 
 
 Pagf? 
 
 133 
 
 s 
 
 Membrana adiposa , its diseases 
 
 — tympani. Vide Ear. 
 
 nictitans. Vide Eye. 
 
 Membrane, what - - - 2, 61 
 
 containing, investing, &c. - - 141 
 
 Mesentery - - - - - 160 
 
 Metacarpus - - - - 33 
 
 Metatarsus , bones of - - - - 37 
 
 Miller, history of the loss of his arm - 321 
 
 lions Veneris - - - - 272 
 
 Mortification, should separate, before we amputate 208 
 Muscles, what ----- 3 
 
 their fibres supposed vesicular - - 62 
 
 rectilineal, penniform, use - - 62, &c. 
 
 of the abdomen - - 67 
 
 - — of the genitals and anus 69 
 
 of the scalp, ear, eye, lips, and nose - 72 
 
 of the os hyoides, tongue, larynx , pharynx , 
 
 and uvula - - - 78 
 
 of the lower jaw * - - 82 
 
 -* of the clavicula and scapida - 83 
 
 • — of the os humeri - 85 
 
 of the fore arm and hand - - 88 
 
 of the head and neck - - - 97 
 
 of respiration, spine, and pelvis - 102 
 
 — of the thigh and leg - -*• - 108 
 
 — of the foot and toes - - - 115 
 
 — of the ossicida auditus - - 307, 309 
 
 Nephrotomy, what passes for that operation - 260 
 
 Nerves, what - - - 2, 225, 246 
 
 ganglions ... 227, 247 
 
 instruments of sensation and of motion 247 
 
 * — whether vibrating cords or traductory tubes 228, 247 
 
XXDEX. 
 
 Nerves, seem to decussate - 
 
 the order of dissecting them - 
 
 of encephalon and medulla spinalis 
 
 — first pair - - 
 
 second pair ------ 
 
 — - — - probably decussate 
 
 =_ — third pair - 
 
 fourth ------- 
 
 fifth 
 
 seventh - 
 
 — — ninth 
 
 tenth ----- 
 
 — — of the medidla spinalis - 
 first cervical - 
 
 second ------ 
 
 third - 
 
 fourth, fifth, sixth, and seventh cervical, with 
 
 the first dorsal - 
 
 the twelve dorsal - - - 
 
 — — - the five lumbar - 
 
 the sacral - - - - - 
 
 Nicholls , Dr. his opinion of the sphenoidal sinuses 
 Nymphce ------- 
 
 Oesophagus - 
 
 Omentum - - 
 
 Os tincce - - - 
 
 — cethmoides ------- 
 
 — coccygis - - 
 
 — femoris - - - - - 
 
 * — front is - - - - - 
 
 «*— humeri 
 
 347 
 
 Page 
 
 294 
 
 240 
 
 229 
 
 230 
 
 231 
 294 
 
 231 
 
 232 
 232 
 
 235 
 
 236 
 236 
 238 
 238 
 240 
 
 240 
 
 241 
 
 241 
 
 242 
 244 
 
 244 
 
 245 
 14 
 
 272 
 
 150 
 
 149 
 
 274 
 
 13 
 
 22, 25 
 3 
 
 12 
 
 31 
 
348 
 
 Index. 
 
 Os innominatum - 
 
 — maxilla: inferioris .... 
 
 superioris ... 
 
 • — nasi - 
 
 — occipitis .... 
 
 — paldti ..... 
 
 — pari et ale .... 
 
 — petrosum - - 
 
 — planum - .... 
 
 — sacrum ....... 
 
 — sphenoides ...... 
 
 ■ — spongiosum ..... 
 
 ■ — temp or is ... - 
 
 • — vomer - 
 
 Ossa etiquetra .... 
 
 Ossicula auditus ..... 
 Ossification in the o'ara mater 
 
 — heart ... 
 
 Ossifying matter, deficient in a lower jaw, and in 
 the rickets - - 
 
 Ovaria 
 Pancreas 
 Paracentesis 
 Parotis , gland 
 
 Patella 
 
 its duct wounded 
 ulcerated 
 
 — how united when broken 
 
 Penis - - - 
 
 Pericardium ... 
 
 containing pus 
 
 adhering to the heart 
 
 Pagce 
 
 28 
 
 17 
 20 
 
 18 
 
 17 
 
 16 
 
 19 
 12 
 15 
 
 18 
 
 22, 25 
 13 
 
 20 
 15 
 20 
 
 8, 11 
 
 307 
 
 319 
 
 319 
 
 5 
 
 274 
 
 165 
 
 111 
 
 142 
 
 143 
 143 
 
 35 
 
 35 
 
 267 
 
 1177 
 
 181 
 
 181 
 
 10 
 
 Pericranium 
 
INDEX. 
 
 349 
 
 Page 
 
 Periosteum - - - - 10 
 
 thickened in rickets 5 
 
 Peritonaeum - - - - 148 
 
 Pi a mater - - - - - 221 
 
 — ossified - 221 
 
 Placenta - - - - 2 81 
 
 its vessels anastomose with those of the uterus 282 
 
 Pleura - - - - - 172 
 
 Pleuritic pains, why more commonly in the left side 178 
 Polypus of blood . 210 
 
 Pope’s eye in brutes .... 214 
 
 Processus ciliares - 292 
 
 Procidentia ani - - - - 157 
 
 Prostatas - 266 
 
 diseased - 266 
 
 Papilla - - - - - 291 
 
 — — how contracted and opened - 292 
 
 — why round and oval in different animals 292 
 
 Radius - 32 
 
 Receptaculum chyli - - - - 168 
 
 Rectum intestinum - - - - 157 
 
 Regio umbilicahs - - - - 133 
 
 Respiration, motions, - 104, &c. 
 
 use - - - - 173 
 
 Reticulum mucosum - - - - 135 
 
 Retina ...... 293 
 
 Ribs, fractured or distorted by careless nurses - 27 
 
 Rupture of matter, and probably of the gut, under 
 
 Fallopius' s ligament - - 47 
 
 of matter, and of blood and matter into the 
 
 fore part of the thigh - - 190 
 
 * — of water - 264 
 
 case of Heysham 
 
350 
 
 INDEX. 
 
 Page 
 
 Kupture, case of White - 324 
 
 Sanguification - - . «■ 217 
 
 Scl'erotis tunica oculi .... 291 
 
 Scapula - - - . . 2 7 
 
 Scarifications, when hurtful - 208 
 
 Scrobicidis cordis - - - . 133 
 
 Scurvy, how affects the cuticula - - 134 
 
 Scull. Vide Cranium. 
 
 fractured - - - * 319 
 
 Secretion, how performed - - . 147 
 
 Seed, the nature of its animalcules - - 269 
 
 Sella turcica - - - * - 1 3 
 
 Sinus , frontal - - - - - 13 
 
 of the os sphenoides - - - 14 
 
 ■ of the maxillary bone - - - 1 9 
 
 ■ — — sometimes imposthumatecl 19 
 
 Slcin - - - - - *135 
 
 Smelling, the sense of - - * 310 
 
 Solids, their proportion to fluids - - 206 
 
 Spine, bones of - - - - 21 
 
 ■ — — why composed of so many bones * 22 
 
 • final causes of its different curvatures - 23 
 
 Spleen - - - - - 167 
 
 Sternum - - - - - 27 
 
 Stomach - - - - - 151 
 
 Stones, extracted from the loins - - 260 
 
 Stone, symptoms of, equivocal - •> 261 
 
 — account of the operation - - 325 
 
 Sublingual gland - 143 
 
 Suppression of urine, in the kidneys and in the blad- 
 der, different - * - 262 
 
 — how to be treated - 262 
 
 Sutures, how formed * - - - « 
 
Index* 
 
 Sutures, what .... 
 
 * particular ones ... 
 
 Tapping for the dropsy 
 
 Tarsus , bones of - - 
 
 Tasting, the sense of 
 
 Teeth 1 
 
 shed - - - - 
 
 Tendons, what - 
 
 pricked in bleeding - 
 
 Testes ...... 
 
 Thymus , gland .... 
 
 Tonsilla glandules .... 
 
 * how extirpated ... 
 
 Tooth-ache, its seat ... - 
 
 'Trepan, not applic-^le at the frontal sinus 
 Tuba Fallopiana .... 
 
 Tumours, small ones under the skin giving exquisite 
 pain ..... 
 
 Vagina ..... 
 
 Vasa deferentia .... 
 
 Vein, what ..... 
 
 ■ coats .... 194, 
 
 ■ why curved in its course 
 
 ■ why cutaneous on the arm 
 
 cava, with its branches 
 
 cephalic, how avoided in cutting issues 
 
 portarum - .... 
 
 • in the feetus ... 
 
 pulmonary ... 
 
 Vena lactea 
 Vertebra 
 
 their classes 
 
 bodies, processes 
 
 551 
 
 Page 
 
 311 
 
 311 
 
 211 
 
 36 
 
 311 
 
 20 
 
 21 
 
 3 
 
 89 
 
 263 
 
 213 
 
 144 
 
 144 
 
 21 
 
 13 
 
 275 
 
 136 
 
 273 
 
 266 
 
 2 
 
 205 
 
 194 
 
 192 
 
 191 
 
 192 
 
 193 
 283 
 183 
 168 
 
 21 
 
 22 
 
 2 ^ 
 
352 
 
 index. 
 
 Vertebra ?, supernumerary - 
 
 Vesiculce seminales - 
 
 Vision, the retina , the organ of 
 
 caused by an impulse on the retina 
 
 how carried on after couching 
 
 — why do objects appear single 
 
 why do not objects appear inverted 
 
 observations from a young gentleman, who 
 
 never saw till couched 
 Vitreous humour - 
 
 Ulna ...... 
 
 Ureters - 
 
 ■ distended in calculous patients 
 
 Urethra . ... . 
 
 — — its glands - 
 
 ■ strictures - 
 
 in women - 
 
 Urine passes only by the ureters 
 Uterus - 
 
 White swelling 
 
 FINIS. 
 
 Page 
 
 28 
 
 266 
 
 294 
 
 297 
 
 298 
 
 295 
 297 
 
 300 
 
 299 
 31 
 
 260 
 
 271 
 
 268 
 
 268 
 
 268 
 
 273 
 
 262 
 
 273 
 
 48 
 

 
 
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 DUKE UNIVERSITY 
 MEDICAL CENTER LIBRARY 
 HISTORY OF MEDICINE COLLECTIONS 
 
 Gift of the Estate of 
 GST Cavanagh 
 
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